ERAS® (Enhanced Recovery After Surgery) is an acronym that many hundreds of patients already know well what it means: an innovative program with a multidisciplinary approach for patients with surgical pathology, which began to be implemented at Hospital da Luz Lisboa (HLL) more than of five years «and with excellent results» , which made HLL an international reference in this program. As the clinical director of Hospital da Luz Lisboa, Rui Maio, explains, this, like other innovative programs in the provision of hospital care, “makes us distinctive, highly differentiating and reveals our ability to absorb innovation and to give our patients the more appropriate care with a view to the best long-term results. In the case of ERAS®, our general surgery team has already integrated it, in a very consolidated way, into its day-to-day activities. And with the best results for our surgical patients.” The objective of ERAS® is to improve perioperative care (those necessary before, during, after surgery and even after hospital discharge, until the patient's complete recovery), to achieve a better recovery for the patient after major surgery. This means continuous monitoring of the patient by a team of different professionals, who are involved at each step of the patient's journey depending on what is recommended for their surgical preparation and recovery after the intervention. The ERAS® patient approach involves multidisciplinary teamwork - a team that includes surgeons, anesthetists, nurses, nutritionists, physiotherapists, managers and medical specialists from other areas when necessary. And it has all the information about the patient in real time, knows how to act at each moment and speaks the same language in front of them. The patient, in fact, is also an important part of this process: he himself is informed about everything, before, during and after treatments, and evaluates (throughout the process and at the end of his recovery) how everything went. As Rui Maio explains, «all ERAS® protocols have an international basis and are considered the best practice today». These are protocols that include intense multidisciplinary work to prepare the patient before surgery - because the better their health status at that moment, the better the therapeutic results of the surgery. This work continues, during and after surgery, always with the same intensity until the patient recovers – a recovery that, for all these reasons, will be faster and more effective from a treatment point of view. In fact, the ERAS® program represents a paradigm shift on several levels. It forces hospital healthcare professionals to adopt new behaviors and patients themselves and their families to actively participate in the entire recovery process, instead of being mere recipients of care. And it shows how some of the most common myths among the population are wrong: here there are no prolonged fasts before surgery, patients get up just a few hours after being operated on and start eating earlier, for example. «Not everyone adapts immediately to this model. But what ERAS® has already demonstrated is that, for professionals, teamwork is much easier and more engaging, and patients feel safer and more confident – they have all the information, they know what will happen at every moment. and every day they meet the team that is accompanying them, who gives them the same instructions and who talks about the entire process in the same terms. All of this contributes to achieving better therapeutic results in each case – with fewer complications, fewer infections and a significant reduction in readmissions – and better hospitalization times, especially considering that these are surgical patients with serious pathologies» , explains one of the surgeons involved. ERAS® teams must adopt the ERAS® Society protocols for each pathology and at HLL those for several pathology are already implemented, which are adapted to the reality of each hospital unit and are regularly updated by the international organization itself. The ERAS program, which was built on the concept of evidence-based medicine, was born from the research of a group of doctors more than ten years ago in Sweden and took the form of a hospital care program aimed at surgical patients, as their results were confirmed. It is a program applicable to all types of pathologies, because the principles of optimized recovery apply to all areas of surgery and medicine: all patients benefit from multidisciplinary treatment and an approach that aims for rapid recovery with the best results.
