{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:29:53Z","timestamp":1790890193193,"version":"4.1.0"},"reference-count":143,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union","award":["2020-1-ES01-KA203-082681"],"award-info":[{"award-number":["2020-1-ES01-KA203-082681"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Despite advancements in surgery, esophagectomy remains one of the most challenging and complex gastrointestinal surgical procedures, burdened by significant perioperative morbidity and mortality rates, as well as high financial costs. Recognizing the need for standardized care provided by a multidisciplinary healthcare team, the EUropean PErioperative MEdical Networking (EUPEMEN) initiative developed a dedicated protocol for perioperative care of patients undergoing esophagectomy, aiming to enhance recovery, reduce morbidity, and homogenize care delivery across European healthcare systems. Methods: Developed through a multidisciplinary European collaboration of five partners, the protocol incorporates expert consensus and the latest scientific evidence. It addresses the entire perioperative pathway, from preoperative preparation to hospital discharge and postoperative recovery, emphasizing patient-centered care, risk mitigation, and early functional restoration. Results: The implementation of the EUPEMEN esophagectomy protocol is expected to improve patient outcomes through a day-by-day structured prehabilitation plan, meticulous intraoperative management, and proactive postoperative rehabilitation. The approach promotes reduced postoperative complications, earlier return to oral intake, and shorter hospital stays, while supporting multidisciplinary coordination. Conclusions: The EUPEMEN protocol for esophagectomy provides a comprehensive guideline framework for optimizing perioperative care in esophageal surgery. In addition, it serves as a practical guide for healthcare professionals committed to advancing surgical recovery and standardizing clinical practice across diverse care environments across Europe.<\/jats:p>","DOI":"10.3390\/diseases13080231","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T08:02:06Z","timestamp":1753257726000},"page":"231","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Optimizing Perioperative Care in Esophageal Surgery: The EUropean PErioperative MEdical Networking (EUPEMEN) Collaborative for Esophagectomy"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0861-8783","authenticated-orcid":false,"given":"Orestis","family":"Ioannidis","sequence":"first","affiliation":[{"name":"Fourth Department of Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital \u201cGeorge Papanikolaou\u201d, 57010 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5650-7319","authenticated-orcid":false,"given":"Elissavet","family":"Anestiadou","sequence":"additional","affiliation":[{"name":"Fourth Department of Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital \u201cGeorge Papanikolaou\u201d, 57010 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5741-2071","authenticated-orcid":false,"given":"Angeliki","family":"Koltsida","sequence":"additional","affiliation":[{"name":"Fourth Department of Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital \u201cGeorge Papanikolaou\u201d, 57010 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7964-1166","authenticated-orcid":false,"given":"Jose M.","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Department of Surgery, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7039-3717","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Department of Surgery, Azienda Unit\u00e0 Sanitaria Locale Ferrara, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier Mart\u00ednez","family":"Ubieto","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Department of Anesthesia, Resuscitation and Pain Therapy, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-5689","authenticated-orcid":false,"given":"Carlo Vittorio","family":"Feo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Azienda Unit\u00e0 Sanitaria Locale Ferrara, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7560-551X","authenticated-orcid":false,"given":"Antonio","family":"Pesce","sequence":"additional","affiliation":[{"name":"Department of Surgery, Azienda Unit\u00e0 Sanitaria Locale Ferrara, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristyna","family":"Rosetzka","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Second Faculty of Medicine, Charles University, Motol University Hospital, 150 06 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0157-5175","authenticated-orcid":false,"given":"Antonio","family":"Arroyo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universidad Miguel Hern\u00e1ndez Elche, Hospital General Universitario Elche, 03203 Elche, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5401-1827","authenticated-orcid":false,"given":"Petr","family":"Koci\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Surgery, Second Faculty of Medicine, Charles University, Motol University Hospital, 150 06 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0623-9074","authenticated-orcid":false,"given":"Luis","family":"S\u00e1nchez-Guill\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universidad Miguel Hern\u00e1ndez Elche, Hospital General Universitario Elche, 03203 Elche, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9440-8282","authenticated-orcid":false,"given":"Ana Pascual","family":"Bellosta","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Department of Anesthesia, Resuscitation and Pain Therapy, Miguel Servet University Hospital, 50009 Zaragoza, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4415-172X","authenticated-orcid":false,"given":"Adam","family":"Whitley","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Kralovske Vinohrady, 100 34 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro Bona","family":"Enguita","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Teresa-Fernand\u00e9z","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, 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