Abstract
BackgroundMultimodal rehabilitation allows optimization of functional recovery in surgery patients by reducing the postoperative stress and hospital stay duration, without increasing the morbidity and mortality. It is reportedly successful in other surgical disciplines, and guidelines for its application to gynecological surgery are available; however, most evidence for these guidelines is derived from observational and/or retrospective studies. Therefore, this study aimed to investigate the applicability of an enhanced recovery after surgery (ERAS) protocol in laparoscopic gynecological surgery and its influence on the postoperative stay, morbidity, mortality, and readmission, through a prospective approach.MethodsThis prospective cohort study was performed on 90 patients who underwent laparoscopic hysterectomy for benign causes from October 2017 to October 2019. Patients in whom the ERAS (ERAS group, n = 30) and traditional (control group, n = 60) protocols were implemented were compared. All patients were followed for 6 months.ResultsThe groups were homogeneous and did not differ significantly with respect to the demographic characteristics (age, ASA score, body mass index), surgical indications, and surgery types. Adherence to the ERAS protocol was over 99%. The postoperative hospital-stay durations were 1.73 days (r = 1–3) and 2.97 days (r = 2–6) in the ERAS and control groups, respectively (p = 0.000). No significant intergroup differences were observed in the rates of complications and readmissions.ConclusionsThe ERAS protocol is applicable in laparoscopic gynecological surgery and can be implemented with good adherence. This can allow optimization of patient recovery by reducing the hospital stay duration, without increasing the rates of morbidity, mortality, or readmission.
Highlights
The practice of multimodal surgical rehabilitation, known as the intensive recovery program, “fast-track surgery,” or “enhanced recovery after surgery” (ERAS), first emerged at the end of the twentieth century with works by Kehlet (Kehlet, 1997) and Bardram et al (Bardram et al, 1995)
ERAS or fast-track surgery protocols were first adopted for colorectal surgeries, the good outcomes obtained have allowed their extension to other specialties
The main objective of this study was to achieve the implementation of an ERAS protocol in laparoscopic gynecological surgery
Summary
The practice of multimodal surgical rehabilitation, known as the intensive recovery program, “fast-track surgery,” or “enhanced recovery after surgery” (ERAS), first emerged at the end of the twentieth century with works by Kehlet (Kehlet, 1997) and Bardram et al (Bardram et al, 1995). ERAS or fast-track surgery protocols were first adopted for colorectal surgeries, the good outcomes obtained have allowed their extension to other specialties These programs have a multidisciplinary approach, and their main objective is to improve patient recovery after surgery. Multimodal rehabilitation allows optimization of functional recovery in surgery patients by reducing the postoperative stress and hospital stay duration, without increasing the morbidity and mortality. It is reportedly successful in other surgical disciplines, and guidelines for its application to gynecological surgery are available; most evidence for these guidelines is derived from observational and/or retrospective studies. This study aimed to investigate the applicability of an enhanced recovery after surgery (ERAS) protocol in laparoscopic gynecological surgery and its influence on the postoperative stay, morbidity, mortality, and readmission, through a prospective approach
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
