Study on the application of enhanced recovery after surgery in patients with endometriosis and adenomyosis

Abstract

Objection To study the safety and effect of enhanced recovery after surgery (ERAS) in patients with endometriosis and adenomyosis. Methods Totally 483 patients with endometriosis and adenomyosis who were admitted to Shengjing Hospital of China Medical University from August 1, 2017 to August 31, 2018 were included. Totally 183 patients underwent ERAS (ERAS group) and 255 patients underwent conventional pathway (control group) were enrolled. Perioperative intestinal function, pain score, inflammatory index, postoperative complications and length of hospital stay were analyzed. Results Compared with control group, the time of postoperative exhaust was earlier [(37.57±12.10) h vs. (47.28±17.36) h, P<0.001]. Postoperative pain score was decreased [8:00 am at postoperative day 1, (2.86±0.89 vs. 2.96±0.92); 8:00 am at postoperative day 2, (1.99±0.73 vs. 2.41±0.82), all P<0.001]. The increase of D-dimer in blood after surgery was lower [1.67(0.68,3.04) vs. 3.17(1.55,5.72), P<0.001]. Postoperative hospital stay was shorter [(5.20±1.07) d vs. (5.52±1.46) d, P=0.009]. Conclusion The application of ERAS path can shorten the postoperative exhaust time of patients with endometriosis, reduce the postoperative pain, improve the postoperative hypercoagulability of blood and reduce the length of hospital stay ERAS is safe, feasible and effective in patients with endometriosis and adenomyosis. Key words: Enhanced recovery after surgery; Endometriosis; Adenomyosis; Pain; Intestinal function