The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
An audit of results of a no-drainage practice policy after hepatectomy.
BACKGROUND It was hypothesized that routine operative drainage is unnecessary for elective hepatic resection . METHODS A review was made of the clinical records of patients undergoing liver resection at a tertiary referral hepatobiliary surgery center since the conclusion in April of 1994 of our previous r and omized drainage trial . The main outcome measures were  operative drainage versus no operative drainage  assessed for possible association with diagnoses , extent of hepatectomy , hospital course , and postoperative radiologic percutaneous drainage procedures . RESULTS Of 1,165 patients , 184 were operatively drained with closed drains according to specific practice criteria and 981 were not subject to operative drainage .  Patients who were not operatively drained had length of stay ( 10.1 days ) , mortality ( 2 % ) , and complication rate ( 34 % ) comparable with the nondrained patients in the previous r and omized trial . Ten percent of these patients required postoperative percutaneous drainage . Patients who were operatively drained were a group who were at higher risk for biliary leakage or infections and consequently had a significantly longer hospital stay , greater mortality , higher complication rate , and required a greater number of percutaneous abdominal drainages . CONCLUSIONS The 84 % of patients not operatively drained had no greater adverse outcome . After hepatic resection , routine drainage of the abdomen is unnecessary
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .