title: Evidence or eminence in abdominal surgery: recent improvements in perioperative care.
abstract: Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery (ERAS), has been generally low. It is of great importance to support the implementation of the ERAS protocol as it has been shown to improve outcomes after a number of surgical procedures, including major abdominal surgery. However, despite an increasing awareness of the importance of structured perioperative management, the implementation of this complex protocol has been slow. Barriers to implementation involve both patient- and staff-related factors as well as practice-related issues and resources. To support efficient and successful implementation, further educational and structural measures have to be made on a national or regional level to improve the standard of general health care. Besides postoperative morbidity, biological and physiological variables have been quite commonly reported in previous ERAS studies. Little information, however, has been obtained on cost-effectiveness, long-term outcomes, quality of life and patient-related outcomes, and these issues remain important areas of research for future studies.
authors.affiliation: Josefin Segelman, Department of Molecular Medicine and Surgery, Karolinska Institutet, 11691 Stockholm, Sweden.
authors.forename: Josefin
authors.initials: J
authors.lastname: Segelman
authors.affiliation: Josefin Segelman, Department of Molecular Medicine and Surgery, Karolinska Institutet, 11691 Stockholm, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Nygren
mesh_terms: D000005:Abdomen / Q000601:surgery*; D019983:Guideline Adherence; D006801:Humans; D019990:Perioperative Care / Q000592:standards*; D011183:Postoperative Complications / Q000517:prevention & control; D017410:Practice Guidelines as Topic / Q000592:standards; D058996:Quality Improvement / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
keywords: Enhanced recovery; Fast track; Perioperative management; Postoperative outcome; Surgery