Standardized Recommendations for the Implementation of Enhanced Recovery Protocols in Thoracic Surgery in Spain: A Delphi Consensus Study

Nestor J. Martinez-Hernandez; Alberto Cabanero-Sanchez; Juan Manuel Corcoles-Padilla; Elisabet Chacon-del Pino; Carlos Fraile-Olivero; Esther Gimenez-Moolhuyzen; Encarna Minana-Aragon; Maria Gorina; Nadia Pires; Maria Alvarez-Orozco; Ignacio Garutti  |  February 17, 2026

This Delphi consensus study established evidence‑based ERAS recommendations for lung resection surgery. Strong agreement was reached on early chest drain removal and the use of digital drainage systems to standardize decision‑making and reduce drainage duration. Integrated with opioid‑sparing analgesia, minimally invasive surgery, and early mobilization, optimized chest drain management was identified as a key postoperative strategy to improve recovery, consistency of care, and resource utilization in thoracic surgery.

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