Esophageal cancer surgery, comprising esophagectomy with radical lymphadenectomy, is a complex procedure associated with considerable morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol which aims to improve perioperative care, minimize complications, and accelerate recovery is showing promise for achieving better perioperative outcomes. ERAS is a multimodal approach that has been reported to shorten the length of hospital stay, reduce surgical stress response, decrease morbidity, and expedite recovery. While ERAS components straddle preoperative, intraoperative, and postoperative periods, they need to be seen in continuum and not as isolated elements. In this review, we elaborate on the components of an ERAS protocol after esophagectomy including preoperative nutrition, prehabilitation, counselling, smoking and alcohol cessation, cardiopulmonary evaluation, surgical technique, anaesthetic management, intra-and postoperative fluid management and pain relief, mobilization and physiotherapy, enteral and oral feeding, removal of drains, and several other components. We also share our own institutional protocol for ERAS following esophageal resections.

The lungs are common sites for the occurrence of saprophytic or invasive mycosis as well as hydatid cysts. The two diseases seldom coexist, and the manifestation is seen as a fungal ball (usually aspergilloma) formed in the cavity left behind after hydatid cystectomy. Active invasion and proliferation of the fungi in the laminated ectocyst or sometimes the pericyst of the hydatid is very unusual. We report such a unique coexistence identified in two of the six surgically excised pulmonary hydatid cysts in the past 2 years. Both were immunocompetent males, who had presented with non-specific symptoms of cough, haemoptysis and chest pain. The septate slender hyphae of the invading fungus resembled those of Aspergillus.

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