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 .
Prospective trial comparing contrast swallow, computed tomography and endoscopy to identify anastomotic leak following oesophagogastric surgery
BACKGROUND Anastomotic leaks are a major complication of oesophagogastric surgery . We compare contrast swallow fluoroscopy , computed tomography ( CT ) with oral contrast and endoscopy in identifying anastomotic leaks following oesophagogastric surgery . METHODS A prospect i ve trial of 38 patients undergoing oesophagogastric resection  was undertaken with informed consent and institutional review board ( ethics committee ) approval . Patients underwent all three investigations ( over 24 hours ) 1 week postoperatively . RESULTS Eight ( 21 % ) had clinical ly apparent leaks . Three pseudo-leaks were suggested on contrast swallow but were confirmed normal on CT and endoscopy . Contrast swallow and CT missed one anastomotic leak each . Endoscopy identified anastomotic defects in three patients , in whom CT and contrast swallow were either normal or conflicting . CONCLUSIONS Routine tests of anastomotic integrity are unnecessary . When clinical ly suspected , contrast swallow or CT with oral contrast will identify most leaks . Endoscopy is useful in cases where there are incongruous results
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 .