Enhanced recovery after surgery (ERAS) pathways have been advanced for the purposes of cost containment, standardization of care, and standardization of surgical outcomes. Adoption of an ERAS pathway has been associated with a shortened length of hospital stay and improved outcomes in colorectal surgery in randomized prospective trials, which has led to the implementation of the ERAS approach in other procedures. Each pathway is specific to a given procedure, and no universal postoperative pathway has been proposed or investigated.

• 2019 ASCRS Practice Guidelines Update. See Table 9 for further details.
• Recent advances in multimodality treatment of appendiceal neoplasm with peritoneal involvement including surgery and intraperitoneal chemotherapy.
• Current trends in intraperitoneal chemotherapy: hyperthermic intraperitoneal chemotherapy (HIPEC) versus early postoperative intraperitoneal chemotherapy (EPIC).
• Recent advances in understanding low-grade appendiceal neoplasm and the focus of current and future clinical trials.

• Classic familial adenomatous polyposis (FAP) syndromes have been expanded to include attenuated FAP (aFAP) and new syndromes, such as MUTYH-associated polyposis (MAP).
• Additional studies support chemoprevention of extracolonic manifestations of FAP, including sulindac with high-dose selective estrogen receptor modulators for FAP-associated desmoid tumors and sulindac with erlotinib for suppression of duodenal polyps.
• The diagnostic criteria for attenuated polyposis syndromes including aFAP and MAP are a cumulative 10 to 100 lifetime polyps, with an APC gene mutation or biallelic MUTYH mutations.

• Classic familial adenomatous polyposis (FAP) syndromes have been expanded to include attenuated FAP (aFAP) and new syndromes, such as MUTYH-associated polyposis (MAP).
• Additional studies support chemoprevention of extracolonic manifestations of FAP, including sulindac with high-dose selective estrogen receptor modulators for FAP-associated desmoid tumors and sulindac with erlotinib for suppression of duodenal polyps.
• The diagnostic criteria for attenuated polyposis syndromes including aFAP and MAP are a cumulative 10 to 100 lifetime polyps, with an APC gene mutation or biallelic MUTYH mutations.

• After emergence from general anesthesia, vital capacity may remain decreased from baseline in 50% of healthy patients for up to 1 week postoperatively.
• A change from the upright to supine position alone reduces FRC by approximately 0.8 to 1.0 L. This underscores the importance of perioperative optimization to prevent postoperative atelectasis.
• There is no prohibitive level of obstruction on spirometry that precludes surgery. Routine perioperative spirometry testing has not been associated with decreased rates of PPCs or mortality, and PFTs should not be the primary or sole determinant for denying surgery.
• Patients with well-controlled asthma that require general anesthesia with endotracheal intubation are not considered at higher risk for PPCs than the general surgical population.
• Obesity by itself has not been consistently demonstrated to be an independent risk factor for PPCs across several meta-analyses. Conversely, underweight patients were found to have a fivefold increased risk of 30-day mortality, underscoring the importance of optimizing nutrition status.

• The combined use of T₁-weighted MRI with a water-sensitive MRI sequence significantly enhances early detection of spondyloarthritis, identifies patients responsive to therapeutic intervention with tumor necrosis factor inhibitors (TNFIs), and constitutes a key prognostic factor for structural progression.
• Treatment of patients with TNFI early in the disease course when radiographic sacroiliitis is not yet evident is highly effective, especially in patients with an elevated C-reactive protein and/or features of inflammation on MRI.
• Treatment targeting interleukin-17 is an effective new treatment option for patients with spondyloarthritis, especially in the setting of concomitant psoriasis.  
• Imaging recommendations that allow for precision in diagnosis.

• Sternal wound complications have dramatically decreased due to improvements in perioperative care of cardiac surgical patients
• Innovation in flap design has made treatment of sternal wound infections more reliable
• New sternal plating systems hold potential to further reduce sternotomy complications in high risk patients

• Newer lung isolation devices may increase the success of placement with decreased difficulty.
• Bronchial blockers can be used for lung isolation in a suspected difficult airway.
• Stepwise ways to predict and manage hypoxia during one-lung ventilation.