Abstract

The potential for accelerated recovery and postoperative rehabilitation by reducing the perioperative stress response was a concept put forth by Kehlet in the 1990s.1,2 Initial implementation of a multimodal enhanced recovery program in Denmark for patients undergoing colorectal surgery significantly reduced postoperative hospital stay from 8 to 12 days to 2 to 3 days and substantially decreased hospital costs.3 After this initial demonstration, a collaboration was formed between 5 centers in northern Europe, including Kehlet's team in Denmark, the Netherlands, Norway, Sweden, and England, to implement and evaluate standardized perioperative protocols.