Outcomes of Implementation of Enhanced Recovery after Surgery in Gynecological Oncology

Document Type : Original research articles

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Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Qena, Egypt.

Abstract

Background: Surgery is crucial for treating gynecological cancers but involves risks of complications and extended hospital stays. Enhanced Recovery After Surgery (ERAS) pathways aim to reduce risks by improving perioperative care, proving effective in various surgeries, including gynecological procedures.
Objectives: To evaluate the outcomes of ERAS guidelines in gynecological oncology.
Patients and methods: A prospective cohort study at South Valley University Hospital comprised 83 women undergoing gynecological cancer surgery from August 2023 to July 2024. Imaging and lab testing before surgery. The ERAS protocol comprised preoperative education, glycemic control, thromboembolism prevention, and bowel preparation. Postoperative therapy emphasised early eating, opioid-sparing analgesia, catheter removal, and ambulation, whereas intraoperative care concentrated on normothermia and infection control.
Results: The average age of the 83 patients was 53.98±13.15 years. Oral ingestion began at 1.33±0.47 hours. Drains were removed on the second day for 67.47%and the third day for 32.53%. Bowel sounds were present at 59.28±46.1 minutes and flatus at 6.83±1.27 hours. Mobility was achieved at 1.33±0.47 hours, and the average hospital stay was 3.42±0.66 days. Surgery duration, surgical packs, and prokinetic use were significantly higher for patients with stool passage on day 3 compared to day 2. Surgery duration was 5 hours on day 3 versus 3.46 hours on day 2(p<0.0001). Surgical towel use was 100%for day 3(6 packs) versus 0%for day 2(3 packs)(p<0.0001). Prokinetic use was 0%for day 3 versus 100%for day 2(p<0.0001).
Conclusion: Patients following ERAS protocols resumed oral intake and bowel functions faster with shorter hospital stays. ERAS also significantly reduced postoperative complications.

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SVU-International Journal of Medical Sciences
Volume 8, Issue 1
January -June
January 2025
Pages 336-350

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