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 .
A prospective study of the association between drainage volume within 24 hours after thoracoscopic lobectomy and postoperative morbidity.
OBJECTIVES We prospect ively analyzed the association between drainage volume and development of complications to clarify the safety of early removal of chest tube after  thoracoscopic lobectomy .  METHODS Between November 2001 and October 2007 , 136 patients with suspected or histologically documented lung cancer were enrolled . Patients with no air leak and increased drainage underwent removal of the chest tube on the day after thoracoscopic lobectomy  independent of the drainage volume . Patients were classified into three groups as tertiles according to the drainage volume . Demographic and perioperative variables were compared among the three groups . Age-sex adjusted odds ratios of the clinical variables associated with development of complications were estimated . In addition , the odds ratios of the drainage volume for development of complications were estimated after adjusting for potentially important factors . RESULTS One hundred patients underwent early removal of the chest tube . Almost all demographic and perioperative variables showed no differences among the three groups ( 0 - 289 mL , n = 33 ; 290 - 399 mL , n = 33 ; and > or=400 mL , n = 34 ) . Tumors in a lower lobe , preoperative stage II or higher , 5 or more anatomic segments resected , and advanced disease were all factors that were associated with higher odds ratios for complications . The drainage volume was not associated with an increased morbidity , even after adjusting for these factors . CONCLUSIONS Early removal of chest tube on the day after thoracoscopic lobectomy , independently of the drainage volume , appears to be safe in well-selected patients
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 .