title: The Development, Application and Analysis of an Enhanced Recovery Programme for Major Oesophagogastric Resection.
abstract: Enhanced recovery programmes improve outcomes in surgery, but their implementation after upper gastrointestinal resection has been limited. The aim of this study was to compare short-term outcomes for patients undergoing oesophagogastric surgery in an enhanced recovery programme (EROS).
  
  
  
  EROS was developed after a multidisciplinary meeting by multiple rounds of revision. EROS was applied to all patients undergoing major upper GI resection at a university teaching hospital in the UK from 20/9/13, with data reviewed at 18/09/15. EROS was assessed to identify predictors for compliance.
  
  
  
  One hundred six patients underwent major upper GI resection including 81 oesophagectomies, 24 gastrectomies and 1 colonic interposition graft. Major complications (Clavien Dindo ≥3) occurred in 12 patients with 1 in-hospital death. Thirty-five patients (44%) were discharged on target day 8 of the EROS programme. Age and complications were independently associated with missing this discharge target.
  
  
  
  Enhanced recovery is feasible and safe after major upper gastrointestinal surgery.
authors.affiliation: Department of Surgery, University Hospital Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK. tju@soton.ac.uk.|Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Somers Cancer Research Building, MP824, Southampton General Hospital, Southampton, Hampshire, SO16 6YD, UK. tju@soton.ac.uk.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Underwood
authors.affiliation: Department of Surgery, University Hospital Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.|Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Somers Cancer Research Building, MP824, Southampton General Hospital, Southampton, Hampshire, SO16 6YD, UK.
authors.forename: F
authors.initials: F
authors.lastname: Noble
authors.affiliation: Department of Surgery, University Hospital Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
authors.forename: N
authors.initials: N
authors.lastname: Madhusudan
authors.affiliation: Department of Surgery, University Hospital Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
authors.forename: D
authors.initials: D
authors.lastname: Sharland
authors.affiliation: Department of Surgery, University Hospital Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
authors.forename: R
authors.initials: R
authors.lastname: Fraser
authors.affiliation: Department of Surgery, University Hospital Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
authors.forename: J
authors.initials: J
authors.lastname: Owsley
authors.affiliation: Department of Surgery, University Hospital Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
authors.forename: M
authors.initials: M
authors.lastname: Grant
authors.affiliation: Department of Surgery, University Hospital Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
authors.forename: J J
authors.initials: JJ
authors.lastname: Kelly
authors.affiliation: Department of Surgery, University Hospital Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK. james.byrne@uhs.nhs.uk.
authors.forename: James P
authors.initials: JP
authors.lastname: Byrne
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000637:transplantation; D004434:Early Ambulation; D016629:Esophagectomy / Q000009:adverse effects; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D019990:Perioperative Care / Q000379:methods*; D016730:Program Development; D016896:Treatment Outcome
keywords: Enhanced recovery; Gastrectomy; Oesophageal surgery; Oesophagectomy; Surgery