Overall , there is little direct evidence for components of ERAS , with much derived from nonesophageal thoracoabdominal surgery .
ERAS in principle seems logical and safe for esophagectomy .
OBJECTIVE This article aims to provide the first systematic review of enhanced recovery after surgery ( ERAS ) programs for  esophagectomy  and generate guidelines .
BACKGROUND ERAS programs use multimodal approaches to reduce complications and accelerate recovery .
Although ERAS is well established in colorectal surgery , experience after esophagectomy has been minimal .
However , esophagectomy remains an extremely high-risk operation , commonly performed in patients with significant comorbidities .
Consequently , ERAS may have a significant role to play in improving outcomes .
No guidelines or review s have been published in esophagectomy .
Successful use of a single chest drain postlobectomy instead of two classical drains: a randomized study.
OBJECTIVE To compare surgical results and complications in the immediate postoperative course between the use of a single drain and two-drain post-anatomical pulmonary resections . PATIENTS AND METHODS Between January 2004 and September 2005 , 143 patients were scheduled for pulmonary lobectomy or bilobectomy for non-small cell lung cancer ( NSCLC ) in our department . Pneumonectomies , wedge resection , and nonresectable thoracotomies were excluded from the study . Hundred and nineteen patients were enrolled in this study . Clinical and surgical variables were collected prospect ively . Lobectomy or bilobectomy and systematic mediastinal node dissection were performed in all cases . The patients were r and omly assigned to receive single ( group A ) or two ( group B ) drains , independent of any preoperative or intraoperative variables . Group A consisted of 60 patients who had  one single drain  sited in the mid-position and group B consisted of 59 patients who had  two classical drains ( apical and basal ) . There were no surgical , oncological , or physiological differences between the groups ( p = NS ) . RESULTS There were no statistically significant differences detected between the groups in relation to postsurgical morbidity or mortality and other issues studied , except in analgesia requirements ( group A less than group B , p<0.05 ) . After drain removal there were no significant differences between the groups in terms of subcutaneous emphysema , new drains needed , residual pleural effusion , or residual space ( p>0.05 ) . CONCLUSIONS In our study , we did not find significant differences between the use of one or two drains after lobectomy or bilobectomy in relation to early postoperative outcome . However , the use of only one drain is more economical and is less painful for patients , without any additional adverse consequences
Overall , there is little direct evidence for components of ERAS , with much derived from nonesophageal thoracoabdominal surgery .
ERAS in principle seems logical and safe for esophagectomy .
OBJECTIVE This article aims to provide the first systematic review of enhanced recovery after surgery ( ERAS ) programs for  esophagectomy  and generate guidelines .
BACKGROUND ERAS programs use multimodal approaches to reduce complications and accelerate recovery .
Although ERAS is well established in colorectal surgery , experience after esophagectomy has been minimal .
However , esophagectomy remains an extremely high-risk operation , commonly performed in patients with significant comorbidities .
Consequently , ERAS may have a significant role to play in improving outcomes .
No guidelines or review s have been published in esophagectomy .