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

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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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Acknowledgments

The authors would like to acknowledge the valuable help of Margaret Ryan and Julie Kiernan (Clinical Nurse Specialists) in the successful implementation of the programme.

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Authors and Affiliations

  1. Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK

    Eva Myriokefalitaki

  2. Gynaecological Oncology, University Hospitals of South Manchester, Manchester, UK

    Eva Myriokefalitaki, M. Smith & A. S. Ahmed

Authors
  1. Eva Myriokefalitaki
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  2. M. Smith
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  3. A. S. Ahmed
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Corresponding author

Correspondence to Eva Myriokefalitaki.

Ethics declarations

Ethical approval

All patients participating in the study provided informed consent to participate in the ERAS implementation programme and approval has been granted from the Hospital Committee as part of clinical audit to review and present our data.

Funding

No funding was obtained to perform data collection, analysis and presentation of this study.

Conflict of interest

None.

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Myriokefalitaki, E., Smith, M. & Ahmed, A.S. Implementation of enhanced recovery after surgery (ERAS) in gynaecological oncology. Arch Gynecol Obstet 294, 137–143 (2016). https://doi.org/10.1007/s00404-015-3934-4

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  • DOI: https://doi.org/10.1007/s00404-015-3934-4

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