Long-Term Outcomes Related to ERAS

A multitude of factors in the perioperative period has an impact on short- and long-term outcomes after surgery. These factors are both unmodifiable patient-related risk factors and modifiable factors related to surgical approach and perioperative treatment protocols. There are apparently essential elements in the enhanced recovery after surgery (ERAS) approach that may have instrumental effects on long-term outcomes. Important aspects are the magnitude of adherence to ERAS, anesthetic modality, analgesic treatment, and magnitude of surgery. There is ample experimental evidence and limited clinical observational studies supporting this. However, the high-quality clinical evidence is lacking in general. Within the next few years, the results from major multi-institutional and multinational randomized clinical trials examining anesthetic modality will help us understand the importance of the intraoperative exposure of the oncological patient to different stressors, such as choice of intravenous or inhalational anesthesia. In general, there is need for more attention to the understanding of the individual risk factors for the patient scheduled for major surgery in order to tailor the right treatment protocol for the right patient at the right time by the right team.