Enhanced recovery after surgery versus traditional care in total pelvic floor reconstruction surgery with transvaginal mesh.

Abstract

To investigate the impact of enhanced recovery after surgery (ERAS) on perioperative outcomes after total pelvic floor reconstruction surgery with transvaginal mesh. A single-center, retrospective observational cohort study involved 177 patients who underwent total pelvic floor reconstruction surgery with transvaginal mesh between August 2015 and November 2017. Eighty-five patients treated according to a traditional protocol formed the control group and 92 patients treated using the ERAS pathway were assigned to the ERAS group. Registered outcomes included demographic characteristics, intraoperative and postoperative data (first assisted walking time, first intestinal exhaust time, length of stay, hospital costs), and complications. The first assisted walking time (40.6±1.48 vs 23.56±3.26hours, P<0.001) and the first intestinal exhaust time (27.65±11.63 vs 18.65±10.68hours, P<0.001) were earlier in the ERAS group. The implementation of the ERAS pathway was associated with shorter length of stay (121.35 vs 70.25hours, P<0.001) and lower hospital costs (46 838.65±2584.08 vs 42 793.57±2560.3 RMB, P<0.001). There was no difference in surgical outcomes or postoperative complications between the two groups. ERAS is safe, economical, and reliable after total pelvic floor reconstruction surgery and promotes perioperative recovery without increasing complication rates.