Differences in quality of evidence and recommendation grade between the 2016 and current updated guideline
| ERAS item | Guidelines 2019 versus 2016 |
| Preadmission information, education and counseling | The same recommendation grade but stronger quality of evidence (from low level to moderate) |
| Prehabilitation | New for 2019 guideline |
| Preoperative bowel preparation | The same recommendation grade and quality of evidence with updates to references |
| Preoperative fasting and carbohydrate treatment | Update to summary and recommendation including addition of new references |
| Venous thromboembolism prophylaxis | Update to summary and recommendation including addition of new information on VTE prophylaxis during chemotherapy |
| Surgical Site Infection (SSI) reduction bundles | New for 2019 guideline (includes antimicrobial prophylaxis, skin prep, prevention of hypothermia, avoidance of drains/tubes, control of perioperative hyperglycemia) |
| Standard anesthetic protocol | Update to summary and recommendation |
| Minimally invasive surgery | The same recommendation grade but stronger quality of evidence (from low level to high) |
| Perioperative fluid management/GDFT | Update including new information on the role of Goal Directed Fluid Therapy (GDFT) |
| Opioid sparing postoperative analgesia | This item is redesigned for the 2019 update and now includes recommendation grade and quality of evidence for several analgesic methods |
| Perioperative nutrition | Update including new information on the role of immunonutrition |
| Prevention of postoperative ileus | Change in both recommendation grade and quality of evidence (now strong/high) |
| Patient Reported Outcomes (PROs) | New for 2019 guideline (including functional recovery) |
| Pelvic Exenteration and HIPEC | New for 2019 guideline |
| Discharge Pathways | New for 2019 guideline |
| Audit and reporting | New for 2019 guideline |
ERAS, Enhanced Recovery After Surgery.