Background: This review aims to present a consensus for optimal perioperative care in colonic surgery
and to provide graded recommendations for items for an evidenced-based enhanced perioperative
protocol.
Methods: Studies were selected with particular attention paid to meta-analyses, randomised controlled
trials and large prospective cohorts. For each item of the perioperative treatment pathway, available
English-language literature was examined, reviewed and graded. A consensus recommendation was
reached after critical appraisal of the literature by the group.
Results: For most of the protocol items, recommendations are based on good-quality trials or metaanalyses of good-quality trials (quality of evidence and recommendations according to the GRADE
system).
Conclusions: Based on the evidence available for each item of the multimodal perioperative-care
pathway, the Enhanced Recovery After Surgery (ERAS) Society, International Association for Surgical
Metabolism and Nutrition (IASMEN) and European Society for Clinical Nutrition and Metabolism (ESPEN)
present a comprehensive evidence-based consensus review of perioperative care for colonic surgery