Title : Advances in enhanced recovery after surgery for perioperative management of esophageal cancer: A narrative review
Abstract:
Background: Esophageal cancer ranks among the most lethal malignancies worldwide, and surgical intervention remains the primary curative modality. However, traditional perioperative care is often associated with significant physiological stress, delayed recovery, and high complication rates. Enhanced Recovery After Surgery (ERAS) protocols represent a paradigm shift in perioperative management, aiming to improve clinical outcomes through evidence-based, multidisciplinary strategies.
Objective: This review examines recent progress in the implementation of ERAS protocols in the perioperative care of esophageal cancer patients, with particular attention to their core components, clinical efficacy, and practical challenges in nursing practice.
Methods: A narrative literature review was conducted by systematically searching domestic and international databases for relevant studies published in recent years. Inclusion criteria focused on clinical trials, cohort studies, and reviews evaluating the application and outcomes of ERAS interventions in esophageal cancer surgery. Key components and effectiveness were synthesized and analyzed thematically.
Results: Current ERAS pathways in esophageal cancer surgery integrate preoperative counseling and nutritional optimization, minimally invasive surgical approaches, multimodal analgesia, early enteral nutrition, and early mobilization. These measures have demonstrated benefits including reduced postoperative complications, shorter length of hospital stay, enhanced gastrointestinal recovery, and improved psychological outcomes. Nonetheless, inconsistent implementation, limited nursing-specific protocols, and insufficient high-level evidence in certain areas remain ongoing challenges.
Conclusion: ERAS has emerged as a valuable approach to optimizing perioperative outcomes in esophageal cancer care. To maximize its effectiveness, future research should focus on standardizing protocol elements, strengthening interdisciplinary collaboration, and tailoring ERAS pathways to cultural and institutional contexts. The role of perioperative nursing, as a core component of ERAS success, warrants further empirical exploration.
