Comparison of enhanced recovery protocol with conventional care in patients undergoing minor gynecologic surgery

Abstract

Introduction: Data regarding the role of the enhanced recovery after surgery (ERAS) protocol in improving postoperative outcomes and postoperative compliance in patients undergoing gynecological surgery, in particular, minor laparoscopic and hysteroscopic gynecological procedures, are limited. Aim: To investigate the impact of the ERAS protocol on time to ambulation, length of stay (LOS), readmissions and postoperative complications in patients undergoing minor gynecological surgical procedures. Material and methods: A total of 104 patients undergoing minor laparoscopic and hysteroscopic gynecological procedures were randomized to the ERAS protocol or conventional care. Time to defecation, ambulation, and solid food intake, bleeding and LOS were recorded for each patient. Results: The amount of intravenous fluid administered in the perioperative (p < 0.001) and postoperative period (p < 0.001) was significantly higher in the conventional care group than in the ERAS group. In addition, time to first defecation (p < 0.001), time to eating solid food (p < 0.001), and time to ambulation (p = 0.008) were shorter in the ERAS group compared to the conventional care group. Length of stay was also significantly shorter in the ERAS group than in the conventional care group (p < 0.001). Conclusions: Implementation of ERAS protocols provides shorter LOS, less fluid intake, early return of bowel function and early mobilization without an increase in complication rate in women undergoing minor laparoscopic or hysteroscopic gynecologic surgery.

Comparative Study of Eras Protocol With Conventional Protocol for Gynecological Surgery

“…In the ERAS group there is improved quality of life in physical and psychological domains with no difference in social and environmental domains. Similarly, Yoong et level with the ERAS program on the scale of 1 to 10, in patients of vaginal hysterectomy before (n = 50) or after (n = 50) ERAS [13].…”

Recent advances in benign gynecological laparoscopic surgery

“…In a recent randomized trial, Yilmaz et al . 91 aimed to investigate the impact of ERAS in patients undergoing minor gynecological surgical procedures (laparoscopic and hysteroscopic). One hundred and four patients were randomly allocated to one of the following study groups: the ERAS group or the conventional care group, which consisted of age-matched control patients who did not receive ERAS interventions.…”

Enhanced Recovery After Surgery (ERAS) in Gynaecology: a meta-analysis

“…The descriptive characteristics of the included studies are shown in Table 2. Three RCTs [17][18][19] and 24 Non-RCTs were included in this meta-analysis, involving a total of 6344 patients.…”

“…Therefore, subjective factors cannot be completely excluded in the study of ERAS pathways. The three RCTs [17][18][19] included in our meta-analysis referred only to the randomization of patients but did not refer to blinded medical personnel or patients. An RCT design for ERAS pathways study also mentions that medical personnel, patients, and family members will not be blinded in the trial due to the procedures differing between groups and physicians who perform the surgery 54 .…”