Sustainability of enhanced recovery programs in colorectal surgery

It is important but difficult to sustain the gains of an effective intervention after its implementation. Although many studies have shown the benefits obtained by implementing enhanced recovery programs (ERPs), sustainability of the program over time after its introduction remains to be elucidated. Herein, I would like to introduce an interesting study by Dr. Veziant et al., recently published in The Surgeon (1). They addressed the issue of whether the application of enhanced recovery surgical components (colonic preparation, surgical approach, nasogastric tube omission and absence of abdominal drainage) had been sustained for 2 years after initial implementation in colorectal surgery. That study retrospectively analyzed the sustainability of ERP in 2,565 patients from 63 colorectal centers using a prospectively maintained database. The results indicated that implementation of the surgical components in the ERP decreased over time.