Enhanced Recovery and Perioperative Optimization in Gastrointestinal and Hepatopancreatobiliary Cancer Surgery

Enhanced Recovery After Surgery (ERAS) programs have changed perioperative care in gastrointestinal (GI) and hepatopancreatobiliary (HPB) oncology by standardizing evidence-based pathways that reduce complications, shorten length of stay, and speed functional recovery. Yet, outcomes still vary widely across centers and patient groups. This gap reflects differences in pathway adherence, local resources, patient frailty, malnutrition, anemia, sarcopenia, and the complexity of major cancer resections. In addition, real-world implementation can be difficult because ERAS requires coordinated teamwork across surgery, anesthesia, nursing, nutrition, and rehabilitation. As oncologic surgery becomes more complex and patients present with higher risk profiles, perioperative optimization and reliable ERAS delivery are central to improving safety, value, and patient-centered outcomes.This Research Topic aims to advance ERAS and perioperative optimization in GI and HPB cancer surgery, with a focus on what improves outcomes in routine practice—not only in ideal settings. We seek contributions that clarify which optimization strategies work best for different procedures and risk profiles, and how to implement them with high fidelity across multidisciplinary teams. Priority areas include prehabilitation programs, nutrition support, anemia and blood-management pathways, frailty and sarcopenia assessment, opioid-sparing analgesia, early mobilization, and complication prevention bundles. We also encourage studies that link ERAS adherence to meaningful endpoints such as major morbidity, readmissions, failure-to-rescue, time to functional recovery, patient-reported outcomes, and timely initiation of adjuvant therapy. By combining pragmatic clinical evidence with implementation and audit frameworks, this Topic aims to support scalable perioperative models that improve outcomes for cancer patients undergoing GI and HPB surgery.We welcome Original Research, Systematic Reviews, Reviews, Mini Reviews, Perspectives, and Methodology articles addressing ERAS and perioperative optimization in GI and HPB surgical oncology, including (but not limited to):- ERAS pathway design, adherence measurement, audit, and quality improvement- Prehabilitation models and patient selection- Nutrition optimization, immunonutrition, and perioperative metabolic care- Frailty, sarcopenia, and risk stratification tools- Anemia management and patient blood management- Opioid-sparing analgesia, PONV prevention, and fluid/temperature management- Complication reduction, readmissions, and failure-to-rescue strategies- Patient-reported outcomes, functional recovery, and “days at home” metrics- Implementation barriers/facilitators, equity, and real-world scalability across centersPlease note: manuscripts consisting solely of bioinformatics or computational analysis of sole public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic. Topic editors: Damiano Caputo, Asif Halimi Source: https://www.frontiersin.org/research-topics/77087/enhanced-recovery-and-perioperative-optimization-in-gastrointestinal-and-hepatopancreatobiliary-cancer-surgery