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Open research questions in Enhanced Recovery After Surgery

342 gap statements mined from Enhanced Recovery After Surgery papers in our 7.9M-paper local library, which holds 1,674 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • The role of phosphate in spine surgery is unclear. There is a need to identify independent predictors of postoperative ileus after transforaminal lumbar interbody fusion.

    Early postoperative hypophosphatemia is an independent predictor of ileus after transforaminal lumbar interbody fusion: a multicenter retrospective cohort study · 2026 · DOI

  • Further studies are needed to confirm the findings and explore the long-term effects of pre-optimization. Research on the cost-effectiveness of ERAS protocols in spinal surgery is needed. Studies on the impact of ERAS protocols on patient outcomes in different surgical specialties are required.

    A prospective study based on ERAS: Did preoperative education and counseling contribute to spine surgery patients pre-optimization? · 2026 · DOI

  • Further studies are needed to confirm the findings of this study and to evaluate the effectiveness of ERAS in a larger, more diverse population. Research is needed to determine the optimal components of an ERAS protocol for patients undergoing endoscopic resection. Studies should investigate the cost-effectiveness of ERAS in therapeutic endoscopy.

    Enhanced recovery after surgery (ERAS) for endoscopic resection of upper gastrointestinal lesions ≤ 2 cm: a single-center, 1:2 randomized, controlled, non-inferiority trial · 2026 · DOI

  • High-quality randomized controlled trials evaluating ERAS in endoscopic resection remain limited. Most existing studies have focused on individual ERAS components rather than on a comprehensive perioperative care pathway. Wide variation in perioperative practice across centers further hinders the standardization and broader implementation of ERAS in therapeutic endoscopy.

    Enhanced recovery after surgery (ERAS) for endoscopic resection of upper gastrointestinal lesions ≤ 2 cm: a single-center, 1:2 randomized, controlled, non-inferiority trial · 2026 · DOI

  • Where oral intake is insufficient, enteral or parenteral nutrition is indicated, with meta-analyses demonstrating potential benefit of early supplementary parenteral nutrition.

    Nutritional rehabilitation strategies in abdominal surgery · 2026 · DOI

  • Current evidence consistently demonstrates an increased incidence of residual gastric contents among patients receiving GLP-1RAs; however, a corresponding increase in pulmonary aspiration has not been established.

    Perioperative management of GLP-1 receptor agonists: adult evidence and future directions · 2026 · DOI

  • Interpretation of the available literature is limited by the rarity of aspiration events, predominantly retrospective study designs, heterogeneous procedural settings, and potential confounding factors.

    Perioperative management of GLP-1 receptor agonists: adult evidence and future directions · 2026 · DOI

  • Multimodal prehabilitation may improve surgical outcomes in selected populations, but its real-world effectiveness remains unclear.

    Effects of multimodal prehabilitation on surgery outcomes: prospective stepped-wedge, hospital-wide implementation study · 2026 · DOI

  • In a pain landscape shaped by opioid exposure, trauma histories, and psychosocial distress, this reductionist approach is insufficient.

    Prehabilitation Reimagined as Policy: A Multidimensional Framework to Reduce Pain, Opioid Use, and Surgical Risk · 2025 · DOI

  • Future studies are needed to examine and modify these protocols, taking into consideration patient factors, disease severity, such as radiation exposure, and the type of reconstruction performed.

    Optimizing Postoperative Mobility: A Review of Enhanced Recovery after Surgery Protocols for Pedicled Flap-Based Pelvic Reconstructions · 2025 · DOI

  • Enhanced recovery after surgery (ERAS) protocols are known to potentially improve the management and outcomes of patients undergoing colorectal surgery, with limited evidence of their implementation in hospital networks and in a large population.

    Implementation of an enhanced recovery after surgery protocol for colorectal cancer in a regional hospital network supported by audit and feedback: a stepped wedge, cluster randomised trial · 2024 · DOI

  • However, robust evidence about the effect of perioperative enhanced recovery concepts in the specific cohort of CD patients is lacking.

    Perioperative Enhanced Recovery Concepts Significantly Improve Postoperative Outcome in Patients with Crohn`s Disease · 2024 · DOI

  • Evidence for the routine use of robotic technology and its impact on short-term outcomes in colon cancer surgery is lacking.

    Surgical stress response in robot-assisted versus laparoscopic surgery for colon cancer (SIRIRALS): randomized clinical trial · 2024 · DOI

  • To further advance the field, a stronger emphasis on high-quality research using objective measurements is warranted.

    Prehabilitation: tertiary prevention matters · 2024 · DOI

  • Fast-track rapid recovery protocols (RRPs) are associated with reduced complications and length of stay in the general population; however, whether that is the case among patients who are socioeconomically disadvantaged in health safety-net hospitals remains poorly defined.

    Is a Rapid Recovery Protocol for THA and TKA Associated With Decreased 90-day Complications, Opioid Use, and Readmissions in a Health Safety-net Hospital? · 2024 · DOI

  • The current literature lacks studies investigating the specific factors influencing early discharge in patients undergoing knee replacement surgery under the ERAS protocol. There is a need to identify independent factors promoting early discharge to inform the development of personalized treatment plans.

    Analysis of Factors Influencing Early Discharge in Patients Undergoing Knee Replacement Surgery Under the ERAS Protocol: A Single-Center Retrospective Cohort Study · 2026 · DOI

  • Fourth, there is currently a lack of standardized ERAS protocols across studies, which urgently need to be improved by a nursing scholar.

    Enhanced recovery after surgery nursing improves postoperative outcomes in laparoscopic radical nephrectomy: a cumulative meta-analysis · 2026 · DOI

  • There is a lack of data on day-case robotic adrenalectomy under an ERAS protocol. The feasibility and outcomes of the procedure are not well understood.

    Day-case robotic adrenalectomy under ERAS protocol: early outcomes from a single-centre experience · 2026 · DOI

  • Unimodal nutritional prehabilitation interventions have mixed evidence of benefit in improving clinical outcomes, such as infectious complications and length of stay.

    Nutritional prehabilitation strategies in abdominal surgery · 2026 · DOI

  • Multidisciplinary perioperative enhanced recovery pathways are increasingly utilized in pediatric scoliosis correction surgery, yet the robustness of their pooled outcome estimates compared to usual care remains inadequately characterized.

    Association of multidisciplinary perioperative enhanced recovery pathways with perioperative outcomes in pediatric scoliosis correction surgery: a systematic review and meta-analysis · 2026 · DOI

  • Our study suggests that corrective measures should be implemented during the preoperative period. Centres providing obstetric care should review their starvation periods before operation and improvement protocols where applicable.

    The impact of perioperative fasting on metabolic status in elective caesarean section patients · 2026 · DOI

  • Lack of high-quality randomised evidence, - Limited long-term evidence, - Non-individualized interventions, - Inappropriate outcome measures, - Publication…

    The prehabilitation paradox in ventral hernia: from universal to personalized care · 2026 · DOI

  • Prioritize RCTs in high-risk patients, - Employ personalized protocols and patient-centered outcomes, - Explore functional nutritional assessments and interventions targeting sarcopenic obesity, - Investigate the efficacy of preoperative weight loss…

    The prehabilitation paradox in ventral hernia: from universal to personalized care · 2026 · DOI

  • Prospective audits and multicenter analyses following the implementation of the EUPEMEN protocol, - Ongoing clinical trials and prospective audits to validate the safety and feasibility of early oral intake after esophagectomy in diverse surgical…

    Optimizing Perioperative Care in Esophageal Surgery: The EUropean PErioperative MEdical Networking (EUPEMEN) Collaborative for Esophagectomy · 2025 · DOI

  • Aim This study aims to evaluate the effects of prehabilitation on the quality of life (QoL) of patients undergoing gastrointestinal cancer resection, addressing the existing gap in knowledge regarding this specific population.

    826 Does Prehabilitation Improve Quality of Life After Gastrointestinal Cancer Resection? · 2024 · DOI

Most-cited papers in Enhanced Recovery After Surgery

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Open questions raised by papers listed on this page include: (1) There is a need to identify independent predictors of postoperative ileus after transforaminal lumbar interbody fusion (“Early postoperative hypophosphatemia is an independent predictor of ileus after…”, 2026); (2) Further studies are needed to confirm the findings and explore the long-term effects of pre-optimization (“A prospective study based on ERAS: Did preoperative education and counseling…”, 2026); (3) Research is needed to determine the optimal components of an ERAS protocol for patients undergoing endoscopic resection (“Enhanced recovery after surgery (ERAS) for endoscopic resection of upper…”, 2026); (4) Current evidence consistently demonstrates an increased incidence of residual gastric contents among patients receiving GLP-1RAs; however, a corresponding increase in pulmonary aspiration has not been established (“Perioperative management of GLP-1 receptor agonists: adult evidence and future…”, 2026); (5) Multimodal prehabilitation may improve surgical outcomes in selected populations, but its real-world effectiveness remains unclear (“Effects of multimodal prehabilitation on surgery outcomes: prospective…”, 2026). 342 gap statements have been mined from Enhanced Recovery After Surgery papers in our 7.9M-paper local library, which holds 1,674 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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