Enhancing the study of enhanced recovery after thoracic surgery: methodology and population-based approaches for the future

Achieving optimal outcomes following thoracic surgery requires a complex multidisciplinary effort spanning the entire peri-operative period. Enhanced recovery after surgery (ERAS) protocols aim to codify essential elements in care across all perioperative settings. As thoracic surgeons have begun to embrace ERAS, identification of optimal protocol elements and novel study endpoints is necessary. In this review we will briefly review the current available evidence for ERAS in thoracic surgery, while focusing on study methods and design. We will discuss methodology for future studies and how a population-based approach can improve the current level of evidence supporting broad implementation of ERAS to thoracic surgery.