Background This review aims to present a consensus for optimal perioperative care in colonic surgery and to provide graded recommendations for items for an evidencedbased enhanced perioperative protocol. Methods Studies were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts. For each item of the perioperative treatment pathway, available English-language literature was examined, reviewed and graded. A consensus recommendation was reached after critical appraisal of the literature by the group. Results For most of the protocol items, recommendations are based on good-quality trials or meta-analyses of goodquality trials (quality of evidence and recommendations according to the GRADE system). Conclusions Based on the evidence available for each item of the multimodal perioperative care pathway, the Enhanced

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In this pilot study, a 1-month trimodal prehabilitation program improved postoperative functional recovery. A randomized trial is ongoing (NCT01356264).

Meaningful changes in postoperative functional exercise capacity can be achieved with a prehabilitation program.

Enhanced recovery is cost-effective compared with conventional perioperative management for elective colorectal resection.