Institutional variations in nutritional aspects of enhanced recovery pathways after elective surgery for colon cancer.

PURPOSE Perioperative nutritional optimisation is one of the key aspects of the Enhanced Recovery after Surgery (ERAS) pathway after elective colorectal cancer resections. Despite the general acceptance of ERAS as a safe and cost-effective perioperative care bundle, significant variations in terms of nutritional support exist among colorectal units. METHODS To assess these variations, we performed a cross-sectional online survey among colorectal surgical residents within a UK region. RESULTS Our survey of practice demonstrated that despite the international recommendations, a considerable percentage of colorectal units would still advocate prolonged fasting prior to surgery without routine use of carbohydrate loading, as well as delaying resumption of oral intake postoperatively. In addition, in almost one in five colorectal units, the patients would not be assessed by the specialist nutrition team for potential support during their hospitalisation. CONCLUSION Therefore, we believe that further education of the medical and allied health professional staff is required regarding the correct implementation of ERAS pathway guidelines after elective surgery for colorectal cancer.