title: Future Perspectives of ERAS: A Narrative Review on the New Applications of an Established Approach.
abstract: ERAS approach (Enhanced Recovery After Surgery) is a multimodal, perioperative pathway designed to achieve early recovery after surgery. ERAS has shown documented efficacy in elective surgery, and the concept of "multimodal" and "multidisciplinary" approach seems still to be of higher importance than each single item within ERAS protocols. New perspectives include the use of ERAS in emergency surgery, where efficacy and safety on outcome have been documented, and flexibility of traditional items may add benefits for traditionally high-risk patients. Obstetric surgery, as well, may open wide horizons for future research, since extremely poor data are currently available, and ERAS benefits may translate even on the baby. Finally, the concept of "outcome" may be extended when considering the specific setting of cancer surgery, in which variables like cancer recurrence, early access to adjuvant therapies, and, finally, long-term survival are as important as the reduced perioperative complications. In this perspective, different items within ERAS protocols should be reinterpreted and eventually integrated towards "protective" techniques, to develop cancer-specific ERAS approaches keeping pace with the specific aims of oncologic surgery.
authors: 2 Anestesia Anestesia, Rianimazione e Terapia del Dolore, Azienda Ospedaliero Universitaria, Via Gramsci 14, 43126 Parma, Italy; Department of Surgical Sciences, University of Parma, Via Gramsci 14, 43126 Parma, Italy; SIMPAR Group (Study in Multidisciplinary Pain Research), Italy.
authors: Dario
authors: 0000-0002-8363-6674
authors: D
authors: Bugada
authors: 2 Anestesia Anestesia, Rianimazione e Terapia del Dolore, Azienda Ospedaliero Universitaria, Via Gramsci 14, 43126 Parma, Italy.
authors: Valentina
authors: 0000-0001-7993-9026
authors: V
authors: Bellini
authors: U.O. Anestesia e Terapia Intensiva Polivalente, Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi, Via Albertoni 15, 40138 Bologna, Italy.
authors: Andrea
authors: 0000-0001-9325-877X
authors: A
authors: Fanelli
authors: 2 Anestesia Anestesia, Rianimazione e Terapia del Dolore, Azienda Ospedaliero Universitaria, Via Gramsci 14, 43126 Parma, Italy; SIMPAR Group (Study in Multidisciplinary Pain Research), Italy.
authors: Maurizio
authors: M
authors: Marchesini
authors: 2 Anestesia Anestesia, Rianimazione e Terapia del Dolore, Azienda Ospedaliero Universitaria, Via Gramsci 14, 43126 Parma, Italy; Department of Surgical Sciences, University of Parma, Via Gramsci 14, 43126 Parma, Italy.
authors: Christian
authors: 0000-0001-9951-5503
authors: C
authors: Compagnone
authors: 2 Anestesia Anestesia, Rianimazione e Terapia del Dolore, Azienda Ospedaliero Universitaria, Via Gramsci 14, 43126 Parma, Italy; Department of Surgical Sciences, University of Parma, Via Gramsci 14, 43126 Parma, Italy.
authors: Marco
authors: 0000-0002-6939-9764
authors: M
authors: Baciarello
authors: 2 Anestesia Anestesia, Rianimazione e Terapia del Dolore, Azienda Ospedaliero Universitaria, Via Gramsci 14, 43126 Parma, Italy; Department of Surgical Sciences, University of Parma, Via Gramsci 14, 43126 Parma, Italy; SIMPAR Group (Study in Multidisciplinary Pain Research), Italy.
authors: Massimo
authors: M
authors: Allegri
authors: 2 Anestesia Anestesia, Rianimazione e Terapia del Dolore, Azienda Ospedaliero Universitaria, Via Gramsci 14, 43126 Parma, Italy; Department of Surgical Sciences, University of Parma, Via Gramsci 14, 43126 Parma, Italy.
authors: Guido
authors: G
authors: Fanelli