SYSTEMATIC REVIEW OF ENHANCED RECOVERY AFTER SURGERY (ERAS ) PROTOCOLS IN MAJOR ABDOMINOPELVIC PROCEDURES : EFFECTS ON RECOVERY AND CLINICAL OUTCOMES
Main Article Content
Keywords
.....
Abstract
Enhanced Recovery after Surgery (ERAS) protocols represent a multimodal, evidence-based approach to perioperative care that aims to reduce surgical stress, maintain physiological function, and accelerate postoperative recovery (1-3). Initially developed for colorectal surgery, ERAS programs have since been adopted across various surgical specialties, including major abdominopelvic procedures such as gynecologic oncology, urologic, and gastrointestinal surgeries (4, 5). These protocols integrate elements such as patient education, optimal analgesia, early mobilization, and nutritional support, shifting the paradigm from traditional perioperative care toward a more coordinated and patient-centered approach (6, 7).
References
1. Bhandoria GP, Bhandarkar P, Ahuja V, Maheshwari A, Sekhon RK, Gultekin M, Ayhan A, Demirkiran F, Kahramanoglu I, Wan YL, Knapp P. Enhanced Recovery After Surgery (ERAS) in gynecologic oncology: an international survey of peri-operative practice. Int J Gynecol Cancer. 2020 Oct 1;30(10):1471–8.
2. Downey CL, Bainbridge J, Jayne DG, Meads DM. Impact of in-hospital postoperative complications on quality of life up to 12 months after major abdominal surgery. Br J Surg. 2023;110(9):1206–12.
3. Ferreira DC, Vieira I, Pedro MI, Caldas P, Varela M. Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis. Healthcare (Basel). 2023;11(5):639.
4. Grossi P. Enhanced Recovery After Surgery (ERAS) Protocols in Orthopaedic Surgery: Opioids or Not Opioids?. J Pain Res. 2025 Dec 31:1683–95.
5. Gupta S, Rane A. Enhanced Recovery after Surgery: Perspective in Elder Women. J Midlife Health. 2021;12(2):93–8.
6. Hirani R, Podder D, Stala O, Mohebpour R, Tiwari RK, Etienne M. Strategies to Reduce Hospital Length of Stay: Evidence and Challenges. Medicina (Kaunas). 2025;61(5):922.
7. Ismail MF, Sharma R. Redefining Perioperative Care: The Pivotal Role of Anesthesiologists in Enhanced Recovery After Surgery (ERAS) Protocols.
8. Jain SN, Lamture Y, Krishna M. Enhanced Recovery After Surgery: Exploring the Advances and Strategies. Cureus. 2023;15(10):e47237.
9. Li D, Jensen CC. Patient Satisfaction and Quality of Life with Enhanced Recovery Protocols. Clin Colon Rectal Surg. 2019;32(2):138–44.
10. Melnyk M, Casey RG, Black P, Koupparis AJ. Enhanced recovery after surgery (ERAS) protocols: Time to change practice?. Can Urol Assoc J. 2011;5(5):342–8.
11. Mithany RH, Daniel N, Shahid MH, Aslam S, Abdelmaseeh M, Gerges F, Gill MU, Abdallah SB, Hannan A, Saeed MT, Manasseh M, Mohamed MS. Revolutionizing Surgical Care: The Power of Enhanced Recovery After Surgery (ERAS). Cureus. 2023;15(11):e48795.
12. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71.
13. Ram C, Li R, Franklin AD, Heiss K, Romain C, Zamora IJ. Can ERAS help reduce health disparities and overcome barriers to equitable surgical care in marginalized communities?. J Pediatr Surg Open. 2024 Jul 1;7:100141.
14. Turaga AH. Enhanced Recovery After Surgery (ERAS) Protocols for Improving Outcomes for Patients Undergoing Major Colorectal Surgery. Cureus. 2023;15(7):e41755.
15. Vaidya H, Rathod J, Parmar H, Vaidya A. The Role of Enhanced Recovery after Surgery (ERAS) Protocols in Reducing Postoperative Complications in Colorectal Surgery. Eur J Cardiovasc Med. 2025 Mar 27;15:737–40.
16. Dellinger AL, Obare SO. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
17. Moher D, Liberati A, Tetzlaff J, Altman DG, Prisma Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010 Jan;8(5):336–41.
18. Jørgensen L, Paludan-Müller AS, Laursen DR, Savović J, Boutron I, Sterne JA, Higgins JP, Hróbjartsson A. Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials: overview of published comments and analysis of user practice in Cochrane and non-Cochrane reviews. Syst Rev. 2016;5:80.
19. Baasan O, Freihat O, Nagy DU, Lohner S. Methodological Quality and Risk of Bias Assessment of Cardiovascular Disease Research: Analysis of Randomized Controlled Trials Published in 2017. Front Cardiovasc Med. 2022;9:830070.
20. Propadalo I, Tranfic M, Vuka I, Barcot O, Pericic TP, Puljak L. In Cochrane reviews, risk of bias assessments for allocation concealment were frequently not in line with Cochrane's Handbook guidance. J Clin Epidemiol. 2019 Feb;106:10–7.
21. Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016 Oct;355:i4919.
22. Greco M, Capretti G, Beretta L, Gemma M, Pecorelli N, Braga M. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World J Surg. 2014 Jun;38(6):1531–41.
23. Ni TG, Yang HT, Zhang H, Meng HP, Li B. Enhanced recovery after surgery programs in patients undergoing hepatectomy: a meta-analysis. World J Gastroenterol. 2015 Aug;21(30):9209–16.
24. Dickson EL, Stockwell E, Geller MA, Vogel RI, Mullany SA, Ghebre R, et al. Enhanced Recovery Program and Length of Stay After Laparotomy on a Gynecologic Oncology Service: a randomized controlled trial. Obstet Gynecol. 2017 Feb;129(2):355–62.
25. Ni X, Jia D, Guo Y, Sun X, Suo J. The efficacy and safety of enhanced recovery after surgery (ERAS) program in laparoscopic digestive system surgery: a meta-analysis of randomized controlled trials. Int J Surg. 2019 Sep;69:108–15.
26. Ni X, Jia D, Chen Y, Wang L, Suo J. Is the Enhanced Recovery After Surgery (ERAS) Program effective and safe in laparoscopic colorectal cancer surgery? A meta-analysis of randomized controlled trials. J Gastrointest Surg. 2019 Jul;23(7):1502–12.
27. Valecha UK, Vohra VK, Patil R, Kulkarni S, Shastri N, Keloth RE, et al. Enhanced recovery after surgery (ERAS) for the anaesthesiologist. Indian J Clin Anaesth. 2020;7:553–62.
28. Vignali A, Elmore U, Guarneri G, De Ruvo V, Parise P, Rosati R. Enhanced recovery after surgery in colon and rectal surgery: identification of predictive variables of failure in a monocentric series including 733 patients. Updates Surg. 2021 Feb;73(1):111–21.
29. Chiewhatpong P, Charoenkwan K, Smithiseth K, Lapisatepun W, Lapisatepun P, Phimphilai M, et al. Effectiveness of enhanced recovery after surgery protocol in open gynecologic oncology surgery: a randomized controlled trial. Int J Gynaecol Obstet. 2022 Nov;159(2):568–76.
30. Cao S, Zhang Y, Lin B, Chen J, Chen X, Zhuang C. Enhanced recovery after gynecological surgery: a meta-analysis of randomized controlled trials. Nurs Health Sci. 2023 Mar;25(1):30–43.
31. Tian Q, Wang H, Guo T, Yao B, Liu Y, Zhu B. The efficacy and safety of enhanced recovery after surgery (ERAS) program in laparoscopic distal gastrectomy: a systematic review and meta-analysis of randomized controlled trials. Ann Med. 2024 Dec;56(1):2306194.
32. Kannan V, Ullah N, Geddada S, Ibrahiam A, Al-Qassab MS, Ahmed O, Malasevskaia I. Impact of Enhanced Recovery After Surgery (ERAS) protocols vs. traditional perioperative care on patient outcomes after colorectal surgery: a systematic review. Patient Saf Surg. 2025;19(1):4.
33. Radha M, Donimath K, Harshitha H, Kurdi M, Theerth K. Outcomes of Enhanced Recovery After Surgery (ERAS) Protocol Implementation in Major Gynecologic Procedures: a prospective case-control study. Cureus. 2025;17(5):e84335.
34. Samuel KA, Kollampare SG, Rai RA. A prospective, observational study to assess the effectiveness of Enhanced Recovery After Surgery (ERAS) protocol in patients undergoing colorectal surgery. J Med Sci. 2025 Jan;11(1):79.
35. Simpson JC, Bao X, Agarwala A. Pain management in Enhanced Recovery After Surgery (ERAS) protocols. Clin Colon Rectal Surg. 2019;32(2):121–8.
2. Downey CL, Bainbridge J, Jayne DG, Meads DM. Impact of in-hospital postoperative complications on quality of life up to 12 months after major abdominal surgery. Br J Surg. 2023;110(9):1206–12.
3. Ferreira DC, Vieira I, Pedro MI, Caldas P, Varela M. Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis. Healthcare (Basel). 2023;11(5):639.
4. Grossi P. Enhanced Recovery After Surgery (ERAS) Protocols in Orthopaedic Surgery: Opioids or Not Opioids?. J Pain Res. 2025 Dec 31:1683–95.
5. Gupta S, Rane A. Enhanced Recovery after Surgery: Perspective in Elder Women. J Midlife Health. 2021;12(2):93–8.
6. Hirani R, Podder D, Stala O, Mohebpour R, Tiwari RK, Etienne M. Strategies to Reduce Hospital Length of Stay: Evidence and Challenges. Medicina (Kaunas). 2025;61(5):922.
7. Ismail MF, Sharma R. Redefining Perioperative Care: The Pivotal Role of Anesthesiologists in Enhanced Recovery After Surgery (ERAS) Protocols.
8. Jain SN, Lamture Y, Krishna M. Enhanced Recovery After Surgery: Exploring the Advances and Strategies. Cureus. 2023;15(10):e47237.
9. Li D, Jensen CC. Patient Satisfaction and Quality of Life with Enhanced Recovery Protocols. Clin Colon Rectal Surg. 2019;32(2):138–44.
10. Melnyk M, Casey RG, Black P, Koupparis AJ. Enhanced recovery after surgery (ERAS) protocols: Time to change practice?. Can Urol Assoc J. 2011;5(5):342–8.
11. Mithany RH, Daniel N, Shahid MH, Aslam S, Abdelmaseeh M, Gerges F, Gill MU, Abdallah SB, Hannan A, Saeed MT, Manasseh M, Mohamed MS. Revolutionizing Surgical Care: The Power of Enhanced Recovery After Surgery (ERAS). Cureus. 2023;15(11):e48795.
12. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71.
13. Ram C, Li R, Franklin AD, Heiss K, Romain C, Zamora IJ. Can ERAS help reduce health disparities and overcome barriers to equitable surgical care in marginalized communities?. J Pediatr Surg Open. 2024 Jul 1;7:100141.
14. Turaga AH. Enhanced Recovery After Surgery (ERAS) Protocols for Improving Outcomes for Patients Undergoing Major Colorectal Surgery. Cureus. 2023;15(7):e41755.
15. Vaidya H, Rathod J, Parmar H, Vaidya A. The Role of Enhanced Recovery after Surgery (ERAS) Protocols in Reducing Postoperative Complications in Colorectal Surgery. Eur J Cardiovasc Med. 2025 Mar 27;15:737–40.
16. Dellinger AL, Obare SO. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
17. Moher D, Liberati A, Tetzlaff J, Altman DG, Prisma Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010 Jan;8(5):336–41.
18. Jørgensen L, Paludan-Müller AS, Laursen DR, Savović J, Boutron I, Sterne JA, Higgins JP, Hróbjartsson A. Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials: overview of published comments and analysis of user practice in Cochrane and non-Cochrane reviews. Syst Rev. 2016;5:80.
19. Baasan O, Freihat O, Nagy DU, Lohner S. Methodological Quality and Risk of Bias Assessment of Cardiovascular Disease Research: Analysis of Randomized Controlled Trials Published in 2017. Front Cardiovasc Med. 2022;9:830070.
20. Propadalo I, Tranfic M, Vuka I, Barcot O, Pericic TP, Puljak L. In Cochrane reviews, risk of bias assessments for allocation concealment were frequently not in line with Cochrane's Handbook guidance. J Clin Epidemiol. 2019 Feb;106:10–7.
21. Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016 Oct;355:i4919.
22. Greco M, Capretti G, Beretta L, Gemma M, Pecorelli N, Braga M. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World J Surg. 2014 Jun;38(6):1531–41.
23. Ni TG, Yang HT, Zhang H, Meng HP, Li B. Enhanced recovery after surgery programs in patients undergoing hepatectomy: a meta-analysis. World J Gastroenterol. 2015 Aug;21(30):9209–16.
24. Dickson EL, Stockwell E, Geller MA, Vogel RI, Mullany SA, Ghebre R, et al. Enhanced Recovery Program and Length of Stay After Laparotomy on a Gynecologic Oncology Service: a randomized controlled trial. Obstet Gynecol. 2017 Feb;129(2):355–62.
25. Ni X, Jia D, Guo Y, Sun X, Suo J. The efficacy and safety of enhanced recovery after surgery (ERAS) program in laparoscopic digestive system surgery: a meta-analysis of randomized controlled trials. Int J Surg. 2019 Sep;69:108–15.
26. Ni X, Jia D, Chen Y, Wang L, Suo J. Is the Enhanced Recovery After Surgery (ERAS) Program effective and safe in laparoscopic colorectal cancer surgery? A meta-analysis of randomized controlled trials. J Gastrointest Surg. 2019 Jul;23(7):1502–12.
27. Valecha UK, Vohra VK, Patil R, Kulkarni S, Shastri N, Keloth RE, et al. Enhanced recovery after surgery (ERAS) for the anaesthesiologist. Indian J Clin Anaesth. 2020;7:553–62.
28. Vignali A, Elmore U, Guarneri G, De Ruvo V, Parise P, Rosati R. Enhanced recovery after surgery in colon and rectal surgery: identification of predictive variables of failure in a monocentric series including 733 patients. Updates Surg. 2021 Feb;73(1):111–21.
29. Chiewhatpong P, Charoenkwan K, Smithiseth K, Lapisatepun W, Lapisatepun P, Phimphilai M, et al. Effectiveness of enhanced recovery after surgery protocol in open gynecologic oncology surgery: a randomized controlled trial. Int J Gynaecol Obstet. 2022 Nov;159(2):568–76.
30. Cao S, Zhang Y, Lin B, Chen J, Chen X, Zhuang C. Enhanced recovery after gynecological surgery: a meta-analysis of randomized controlled trials. Nurs Health Sci. 2023 Mar;25(1):30–43.
31. Tian Q, Wang H, Guo T, Yao B, Liu Y, Zhu B. The efficacy and safety of enhanced recovery after surgery (ERAS) program in laparoscopic distal gastrectomy: a systematic review and meta-analysis of randomized controlled trials. Ann Med. 2024 Dec;56(1):2306194.
32. Kannan V, Ullah N, Geddada S, Ibrahiam A, Al-Qassab MS, Ahmed O, Malasevskaia I. Impact of Enhanced Recovery After Surgery (ERAS) protocols vs. traditional perioperative care on patient outcomes after colorectal surgery: a systematic review. Patient Saf Surg. 2025;19(1):4.
33. Radha M, Donimath K, Harshitha H, Kurdi M, Theerth K. Outcomes of Enhanced Recovery After Surgery (ERAS) Protocol Implementation in Major Gynecologic Procedures: a prospective case-control study. Cureus. 2025;17(5):e84335.
34. Samuel KA, Kollampare SG, Rai RA. A prospective, observational study to assess the effectiveness of Enhanced Recovery After Surgery (ERAS) protocol in patients undergoing colorectal surgery. J Med Sci. 2025 Jan;11(1):79.
35. Simpson JC, Bao X, Agarwala A. Pain management in Enhanced Recovery After Surgery (ERAS) protocols. Clin Colon Rectal Surg. 2019;32(2):121–8.
Article Sidebar
Published
Jul 17, 2025
Article Details
How to Cite
Dr. Priya Jindal, Dr. Anshu Mujalda, Dr. Anwesha Sarkar, Dr. Aisha Khader, Dr. Aditi Yadav, Dr. Reema Aggarwal, & Dr. Pankaj Kumar. (2025). SYSTEMATIC REVIEW OF ENHANCED RECOVERY AFTER SURGERY (ERAS ) PROTOCOLS IN MAJOR ABDOMINOPELVIC PROCEDURES : EFFECTS ON RECOVERY AND CLINICAL OUTCOMES. Journal of Population Therapeutics and Clinical Pharmacology, 32(6), 758-767. https://doi.org/10.53555/ys1hbq77
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biographies
Dr. Priya Jindal
Associate Professor, Department of Obs & Gynae, Adesh Medical College, Mohri, Shahbad, HaryanaDr. Anshu Mujalda
Assistant Professor, Obstetrics & Gynecology, Gandhi Medical College, BhopalDr. Anwesha Sarkar
Senior Resident, Anesthesiology, MMIMSR, MullanaDr. Aisha Khader
Assistant Professor, Anesthesiology, MMIMSR, MullanaDr. Aditi Yadav
MBBS Intern, Obs & Gynae, Adesh Medical College, Mohri, Shahbad, HaryanaDr. Reema Aggarwal
Assistant Professor, Anesthesiology, Adesh Medical College, Mohri, Shahbad, HaryanaDr. Pankaj Kumar
Assistant Professor, Anesthesiology, Adesh Medical College, Mohri, Shahbad, HaryanaHow to Cite
Dr. Priya Jindal, Dr. Anshu Mujalda, Dr. Anwesha Sarkar, Dr. Aisha Khader, Dr. Aditi Yadav, Dr. Reema Aggarwal, & Dr. Pankaj Kumar. (2025). SYSTEMATIC REVIEW OF ENHANCED RECOVERY AFTER SURGERY (ERAS ) PROTOCOLS IN MAJOR ABDOMINOPELVIC PROCEDURES : EFFECTS ON RECOVERY AND CLINICAL OUTCOMES. Journal of Population Therapeutics and Clinical Pharmacology, 32(6), 758-767. https://doi.org/10.53555/ys1hbq77