Implementing a structured Enhanced Recovery After Surgery (ERAS) protocol reduces length of stay after abdominal hysterectomy

Abstract

Introducing the ERAS protocol for abdominal hysterectomy reduced length of stay without increasing complications or readmissions.

Enhanced Recovery after Surgery Protocol in Abdominal Hysterectomies for Malignant versus Benign Disease

“…This was a mixture of patients with malignant and benign disease, where the proportion of women discharged at the target LOS of 2 days increased from 56 to 73% [11]. The aim of the present study was to compare the patient group with malignant diagnosis with the group undergoing surgery for benign disease, in a prospective cohort study, with both groups undergoing the same surgical procedure.…”

Increased postoperative day one discharges after implementation of a hysterectomy enhanced recovery pathway: a retrospective cohort study

“…Implementation of an enhanced recovery pathway at our institution readied patients for a discharge on POD 1, which is earlier than other studies of gynecological patients. [16][17][18][19] Studies of enhanced recovery in gynecology have focused on laparoscopic surgery or featured a mix of benign and malignant surgical indications. 15,16 We describe a pathway oriented specifically at an open surgical approach for treating benign disease that allows practitioners to identify patients appropriate for HER pathway application.…”

“…11 The few multifaceted enhanced recovery pathways currently described in the literature enrolled fewer than 100 patients, 12,13 were specific to minimally invasive procedures, 12,14 or mixed benign and malignant diagnoses. 15,16 Some investigations did not compare their pathway to a previous standard of care. 17 To guide the development of our pathway, we performed a structured review of the literature using PubMed, Google Scholar, and Embase databases to identify evidence-based interventions associated with improved pain control and functional recovery, decreased nausea and vomiting, or decreased LOS after gynecologic surgery.…”

The physiotherapy management of patients undergoing abdominal surgery

“…Elements include minimal preoperative bowel preparation and fasting, admission on the day of surgery, aggressive early ambulation, strict analgesia protocols, early postoperative introduction of oral fluids and food, and minimal use of drips and drains. These pathways are safe, feasible and reduce complication rates and LOS across all types of abdominal surgery (Adamina et al 2011, Cerantola et al 2013, Coolsen et al 2013, Li et al 2012, Lin et al 2011, Varadhan et al 2010, Wijk et al 2014.…”