Enhanced Recovery After Surgery: Optimizing Outcomes in Abdominal Procedures
DOI:
https://doi.org/10.64784/017Palabras clave:
Enhanced Recovery After Surgery, abdominal surgery, perioperative care, surgical outcomes, complications, Latin America, hospital length of stayResumen
Enhanced Recovery After Surgery (ERAS) programs represent a transformative approach to perioperative care, aiming to minimize surgical stress, enhance recovery, and improve clinical outcomes. This review analyzes current international evidence regarding the implementation and impact of ERAS protocols in abdominal surgical procedures, focusing on global comparisons and regional adaptation within Mexico, Colombia, and Ecuador. Data were obtained from high-impact scientific publications between 2019 and 2025, including guidelines, meta-analyses, and multicenter studies. Using a mixed analytical approach supported by the DMAIC methodology, results were organized into thematic categories addressing adherence, complications, hospital length of stay, and patient satisfaction. Findings reveal that ERAS adherence rates above 70% are consistently associated with a 30–45% reduction in hospital stay and a 25–40% reduction in postoperative complications. International centers—particularly in Europe and North America—demonstrate mature and standardized implementation, while Latin American hospitals show progressive but uneven integration. Nevertheless, regional programs have achieved measurable improvements even under limited-resource conditions. The analysis confirms that ERAS success depends primarily on multidisciplinary coordination, continuous training, and institutional auditing rather than technological capacity. Overall, ERAS constitutes a paradigm shift in modern surgery, emphasizing efficiency, safety, and patient-centered recovery. Its broader adoption across Latin America will be key to improving surgical outcomes and promoting equity in global healthcare.
Referencias
1. Burchard, P. R., Dave, Y. A., Loria, A. P., … & Hernandez-Alejandro, R. (2022). Early postoperative ERAS compliance predicts decreased length of stay and complications following liver resection. HPB (Oxford), 24(9), 1425–1432. https://doi.org/10.1016/j.hpb.2022.01.008
2. Gillis, C., & Carli, F. (2022). Prehabilitation, enhanced recovery after surgery, or both? A narrative review. British Journal of Anaesthesia, 128(5), 884–899. https://doi.org/10.1016/j.bja.2021.12.021
3. Gustafsson, U. O., Braga, M., Ljungqvist, O., … & Demartines, N. (2025). Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Surgery. https://doi.org/10.1016/j.surg.2025.109397
4. Hajibandeh, S., & Hajibandeh, S. (2020). Meta-analysis of Enhanced Recovery After Surgery (ERAS) protocols in emergency abdominal surgery. World Journal of Surgery, 44(4), 1336–1348. https://doi.org/10.1007/s00268-019-05357-5
5. Irani, J. L., Gurland, B., Delaney, C. P., & Champagne, B. J. (2023). SAGES/ASCRS recommendations regarding enhanced recovery guidelines for laparoscopic colon and rectal surgery. Surgical Endoscopy, 37(1), 5–30. https://doi.org/10.1007/s00464-022-09758-x
6. Joliat, G. R., Scott, M., Demartines, N., & Ljungqvist, O. (2023). Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World Journal of Surgery. https://doi.org/10.1007/s00268-022-06732-5
7. Melloul, E., Lassen, K., Roulin, D., … & Demartines, N. (2020). Guidelines for perioperative care for pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS®) recommendations 2019. World Journal of Surgery, 44, 2056–2084. https://doi.org/10.1007/s00268-020-05462-w
8. Mortensen, K., Nilsson, M., Slim, K., … & Kehlet, H. (2014). Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. British Journal of Surgery, 101(10), 1209–1229. https://doi.org/10.1002/bjs.9582
9. Nelson, G., Altman, A. D., Meyer, L. A., … & Ljungqvist, O. (2023). Enhanced recovery after surgery (ERAS®) society guidelines for gynecologic oncology: Addressing implementation challenges—2023 update. Gynecologic Oncology. https://pubmed.ncbi.nlm.nih.gov/37086524/
10. Nelson, G., Bakkum-Gamez, J., Kalogera, E., … & Dowdy, S. C. (2019). Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery after Surgery (ERAS®) Society recommendations—2019 update. International Journal of Gynecological Cancer, 29(4), 651–668. https://doi.org/10.1136/ijgc-2019-000356
11. Noba, L., Rodgers, S., Doi, L., Chandler, C., Hariharan, D., & Yip, V. (2023). Costs and clinical benefits of enhanced recovery after surgery (ERAS) in pancreaticoduodenectomy: An updated systematic review and meta-analysis. Journal of Cancer Research and Clinical Oncology, 149, 6639–6660. https://doi.org/10.1007/s00432-022-04508-x
12. Pagano, E., Palestra, F., Morando, A., … & Sciannameo, V. (2024). Implementation of an enhanced recovery after surgery protocol for colorectal cancer: Audit & feedback improves compliance and reduces length of stay. BMJ Quality & Safety, 33(6), 363–371. https://qualitysafety.bmj.com/content/33/6/363
13. Peden, C. J., Aggarwal, G., Aitken, R. J., … & Scott, M. J. (2021). Guidelines for perioperative care for emergency laparotomy (ERAS®) Society recommendations: Part 1—Preoperative: Diagnosis, rapid assessment and optimization. World Journal of Surgery, 45(5), 1272–1290. https://doi.org/10.1007/s00268-021-05994-9
14. Peden, C. J., Scott, M. J., Dickerson, J., … & Demartines, N. (2023). ERAS® Society consensus guidelines for emergency laparotomy: Part 3—Organizational aspects and general considerations. World Journal of Surgery. https://doi.org/10.1007/s00268-023-07039-9
15. Roulin, D., & Demartines, N. (2022). Principles of enhanced recovery in gastrointestinal surgery. Langenbeck’s Archives of Surgery, 407, 2619–2627. https://doi.org/10.1007/s00423-022-02602-9
16. Sauro, K. M., Holodinsky, J. K., Tangri, N., … & Ahmed, S. B. (2024). Enhanced recovery after surgery guidelines and hospital length of stay, readmission, complications, and mortality: A meta-analysis of randomized clinical trials. JAMA Network Open, 7(6), e2417310. https://doi.org/10.1001/jamanetworkopen.2024.17310
17. Scott, M. J., Peden, C. J., Balasooriya-Smeekens, C., … & Demartines, N. (2023). Consensus guidelines for perioperative care for emergency laparotomy (ERAS®) Society recommendations: Part 2—Intra- and postoperative care. World Journal of Surgery. https://doi.org/10.1007/s00268-023-07020-6
18. Song, J. H., Choi, G. S., & Park, J. S. (2024). Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: A narrative review. Electrolyte & Blood Pressure (EMJ). https://e-emj.org/journal/view.php?doi=10.12771/emj.2024.e69
19. Stenberg, E., Szabo, E., Ågren, G., … & Thorell, A. (2022). Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations—A 2021 update. World Journal of Surgery. https://doi.org/10.1007/s00268-021-06394-9
20. Tong, E., Varadhan, K. K., Neal, K. R., Humes, D. J., & Fearon, K. C. H. (2022). Effects of preoperative carbohydrate loading on recovery after elective surgery as part of an enhanced recovery pathway: A review. Frontiers in Nutrition, 9, 951676. https://doi.org/10.3389/fnut.2022.951676
