Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018

World J Surg. 2019 Mar;43(3):659-695. doi: 10.1007/s00268-018-4844-y.


Background: This is the fourth updated Enhanced Recovery After Surgery (ERAS®) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded recommendations for each ERAS item within the ERAS® protocol.

Methods: A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.

Results: All recommendations on ERAS® protocol items are based on best available evidence; good-quality trials; meta-analyses of good-quality trials; or large cohort studies. The level of evidence for the use of each item is presented accordingly.

Conclusions: The evidence base and recommendation for items within the multimodal perioperative care pathway are presented by the ERAS® Society in this comprehensive consensus review.

Publication types

  • Review

MeSH terms

  • Clinical Protocols
  • Colon / surgery*
  • Digestive System Surgical Procedures* / methods
  • Elective Surgical Procedures* / methods
  • Humans
  • Perioperative Care* / methods
  • Practice Guidelines as Topic*
  • Recovery of Function
  • Rectum / surgery*