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The group consisted of seven members from the ERAS\u00ae Society and eight members from LMIC's. An updated systematic literature search and evaluation of evidence from previous ERAS\u00ae guidelines was performed by the leading authors of the Colorectal (2018) and Gynecologic (2019) surgery guidelines (Gustafsson et al in World J Surg 43:6592\u2013695, Nelson et al in Int J Gynecol Cancer 29(4):651\u2013668). Meta\u2010analyses randomized controlled trials (RCTs), prospective and retrospective cohort studies from both HIC's and LMIC's were considered for each perioperative item. The members in the LMIC group then applied the current evidence and adapted the recommendations for each intervention as well as identifying possible new items relevant to LMIC's. The Grading of Recommendations, Assessment, Development and Evaluation system (GRADE) methodology was used to determine the quality of the published evidence. The strength of the recommendations was based on importance of the problem, quality of evidence, balance between desirable and undesirable effects, acceptability to key stakeholders, cost of implementation and specifically the feasibility of implementing in LMIC's and determined through discussions and consensus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In addition to previously described ERAS\u00ae Society interventions, the following items were included, revised or discussed: the Surgical Safety Checklist (SSC), preoperative routine human immunodeficiency virus (HIV) testing in countries with a high prevalence of HIV\/AIDS (CD4 and viral load for those patients that are HIV positive), delirium screening and prevention, COVID 19 screening, VTE prophylaxis, immuno\u2010nutrition, prehabilitation, minimally invasive surgery (MIS) and a standardized postoperative monitoring guideline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These guidelines are seen as a starting point to address the urgent need to improve perioperative care and to effect data\u2010driven, evidence\u2010based care in LMIC's.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-022-06587-w","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T16:02:50Z","timestamp":1654012970000},"page":"1826-1843","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":92,"title":["Guidelines for Perioperative Care in Elective Abdominal and Pelvic Surgery at Primary and Secondary Hospitals in Low\u2013Middle\u2010Income Countries (LMIC's): Enhanced Recovery After Surgery (ERAS) Society Recommendation"],"prefix":"10.1002","volume":"46","author":[{"given":"Ravi","family":"Oodit","sequence":"first","affiliation":[{"name":"Division of Global Surgery University of Cape Town Anzio Road, Observatory Cape Town Western Cape South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce M.","family":"Biccard","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Groote Schuur Hospital University of Cape Town Anzio Road, Observatory Cape Town Western Cape South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Panieri","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Groote Schuur Hospital University of Cape Town Anzio Road, Observatory Cape Town Western Cape South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian O.","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Anesthesia Department Hospital Italiano de Buenos Aires Teniente General Juan Domingo Peron, 4190 C1199ABB Beunos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna R. 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