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Archives of Gynecology and Obstetrics

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01-07-2016 | Gynecologic Oncology

Implementation of enhanced recovery after surgery (ERAS) in gynaecological oncology

Authors: Eva Myriokefalitaki, M. Smith, A. S. Ahmed

Published in: Archives of Gynecology and Obstetrics | Issue 1/2016

Abstract

Objectives

To evaluate the outcomes of enhanced recovery after surgery (ERAS) implementation in a gynaecological oncology centre.

Method

Non-randomised control trial, evaluating morbidity outcomes, before and after implementation of ERAS programme. All consecutive major gynaecological oncology operations performed during two specified periods were included. Data were collected prospectively for a study group in the initial 7.5 months of ERAS implementation and compared with a consecutive historic control group from the exact same period, the year before. Patients’ characteristics and perioperative outcomes were compared. Further analysis stratified abdominal and laparoscopic surgery.

Results

In total, 265 cases identified; 99 patients followed ERAS and 99 historic controls, managed with a traditional peri-operative approach, the exact same period the year before (vulval surgery excluded, 67 cases). Groups were comparable in demographics and co-morbidities (age, BMI, ASA, WHO), level of surgery and 30 days post-operative complication (grading Clavien-Dindo classification) and readmission rates (p > 0.05). Overall, the post-operative length of hospital stay (LOS) was significantly reduced for patients who followed ERAS (4.29 ± 2.78 days versus 7.23 ± 5.68 days, p < 0.001). Stratification to subgroups was based on the type of surgery, abdominal versus laparoscopic. Those who underwent abdominal surgery and followed ERAS benefited the maximum (LOS: 5.09 ± 2.74 days versus 8.70 ± 5.75, p < 0.001)

Conclusions

ERAS programme is feasible and safe in Gynae-oncology. In this study, there was a reduction of 3.61 (SE: 0.78, CI 95 %) days in the total LOS, in major abdominal Gynae-oncology surgery (level 3 and 4) without affecting complication or readmission rates.

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Title: Implementation of enhanced recovery after surgery (ERAS) in gynaecological oncology
Authors: Eva Myriokefalitaki
M. Smith
A. S. Ahmed
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 1/2016
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-015-3934-4

At a glance: The STEP trials

Springer Medicine

Implementation of enhanced recovery after surgery (ERAS) in gynaecological oncology

Abstract

Objectives

Method

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Method

Results

Conclusions

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