Enhanced Recovery After Surgery Among Obese Gynecology Oncology Patients [08H

Abstract

INTRODUCTION: Benefits of Enhanced Recovery After Surgery (ERAS) protocols are well-established for the general surgical population, but there is limited studies specifically evaluating the efficacy in obese patients. We implemented an ERAS protocol among gynecologic oncology patients undergoing laparotomy and assessed outcomes in obese (≥30) vs non-obese. METHODS: The gynecologic oncology department implemented an ERAS protocol as a quality improvement initiative in patients undergoing laparotomy. Data was prospectively collected on patients where ERAS was implemented and compared to historical controls (pre-ERAS). A descriptive analysis on outcomes was assessed by comparing obese (BMI>30) and non-obese patients. RESULTS: The average length of stay (LOS) in ERAS vs pre-ERAS is 3.5 days vs 4.7 days (P=.002). Non-obese ERAS vs pre–ERAS LOS 3.2 days vs 4.6 days (P=.05). However, obese patients tend to have longer LOS, 3.2 days vs 3.8 days (NS). Although PO analgesics were used per ERAS protocol, obese patients used patient-controlled analgesia (PCA) more often than non-obese patients (13% vs 3%). The rate of complications (9-15%) and readmissions (0-5%) was similar among all groups. CONCLUSION: ERAS is effective, but there is a trend towards increased LOS and PCA usage in obese patients; though there is no difference in post-op complications and readmissions. Further investigation is needed to determine how obesity affects recovery after surgery.