title: Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations.
abstract: BACKGROUND
  Application of evidence-based perioperative care protocols reduces complication rates, accelerates recovery and shortens hospital stay. Presently, there are no comprehensive guidelines for perioperative care for gastrectomy.
  
  
  METHODS
  An international working group within the Enhanced Recovery After Surgery (ERAS®) Society assembled an evidence-based comprehensive framework for optimal perioperative care for patients undergoing gastrectomy. Data were retrieved from standard databases and personal archives. Evidence and recommendations were classified according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system and were discussed until consensus was reached within the group. The quality of evidence was rated 'high', 'moderate', 'low' or 'very low'. Recommendations were graded as 'strong' or 'weak'.
  
  
  RESULTS
  The available evidence has been summarized and recommendations are given for 25 items, eight of which contain procedure-specific evidence. The quality of evidence varies substantially and further research is needed for many issues to improve the strength of evidence and grade of recommendations.
  
  
  CONCLUSIONS
  The present evidence-based framework provides comprehensive advice on optimal perioperative care for the patient undergoing gastrectomy and facilitates multi-institutional prospective cohort registries and adequately powered randomized trials for further research.
authors.affiliation: Department of Gastrointestinal and Hepatobiliary Surgery, University Hospital of Northern Norway, Tromsø, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Mortensen
authors.forename: M
authors.initials: M
authors.lastname: Nilsson
authors.forename: K
authors.initials: K
authors.lastname: Slim
authors.forename: M
authors.initials: M
authors.lastname: Schäfer
authors.forename: C
authors.initials: C
authors.lastname: Mariette
authors.forename: M
authors.initials: M
authors.lastname: Braga
authors.forename: F
authors.initials: F
authors.lastname: Carli
authors.forename: N
authors.initials: N
authors.lastname: Demartines
authors.forename: S M
authors.initials: SM
authors.lastname: Griffin
authors.forename: K
authors.initials: K
authors.lastname: Lassen
mesh_terms: D000428:Alcohol Drinking / Q000517:prevention & control; D015360:Analgesia, Epidural / Q000379:methods; D019072:Antibiotic Prophylaxis; D000925:Anticoagulants / Q000627:therapeutic use; D001510:Bed Rest; D002400:Cathartics / Q000627:therapeutic use; D003376:Counseling; D019299:Decompression, Surgical / Q000379:methods; D019587:Dietary Supplements; D004322:Drainage / Q000379:methods; D019317:Evidence-Based Medicine; D005743:Gastrectomy / Q000379:methods*; D044882:Glucose Metabolism Disorders / Q000517:prevention & control; D006801:Humans; D007035:Hypothermia / Q000517:prevention & control; D009407:Nerve Block / Q000379:methods; D018529:Nutritional Support; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D000074606:Smoking Prevention; D014883:Water-Electrolyte Imbalance / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D002400:Cathartics