Comparison of enhanced recovery protocol with conventional care in patients undergoing urogynecological surgery

Yilmaz G., Can E., Omaygenc D. O., Tuten N., Olmez F., Kiyak H., ...More

CESKA GYNEKOLOGIE-CZECH GYNAECOLOGY, vol.87, no.4, pp.232-238, 2022 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 87 Issue: 4
  • Publication Date: 2022
  • Doi Number: 10.48095/cccg2022232
  • Journal Name: CESKA GYNEKOLOGIE-CZECH GYNAECOLOGY
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, EMBASE
  • Page Numbers: pp.232-238
  • Keywords: enhanced recovery after surgery, gynecologic surgery, pelvic organ prolapse, postoperative care, postoperative complications, ERAS(R) SOCIETY RECOMMENDATIONS, RANDOMIZED CONTROLLED-TRIALS, PERIOPERATIVE CARE, RADICAL CYSTECTOMY, COLORECTAL SURGERY, INSULIN-RESISTANCE, POSTOPERATIVE CARE, GUIDELINES, METAANALYSIS, CANCER
  • Istanbul University Affiliated: No

Abstract

: Objective: The impact of enhanced recovery after surgery (ERAS) protocol on postoperative outcomes after urogynecological surgery is yet to be a matter of investigation. This study sought to evaluate this issue by comparing the patients who had conventional or ERAS--guidedperioperative care for several clinical end-points including ambulation, length of hospital stay (LOS), readmissions, and postoperative complications.Materials and methods: A total of 121 patients undergoing pelvic organ prolapse surgery were allocated to two study arms, ERAS protocol (Group E) or conventional care (Group C). Variables reflecting the restoration of appetite and bowel movements, bleeding events, other complications, LOS and readmissions were compared between the groups.Results: The patients in Group C signifi cantly received a more intensive intravenous fluid treatment compared to Group E (2,760 +/- 656 vs. 1,045 +/- 218 mL, P < 0.001). Time required for first flatus, first defecation, eating solid food, and ambulation (P < 0.001) were also longer in the former group of patients. Moreover, LOS was significantly reduced when the ERAS protocol was applied (2.5 +/- 1.1 vs. 2.0 +/- 0.6 days, P < 0.001). On the other hand, the two groups were similar with respect to the frequency of the postoperative complications, including surgical site infections, cardiovascular complications, non-specific abdominal pain, sub-ileus, blood loss and readmission rate. Conclusion: In our sample population, ERAS protocol led to early initiation of oral intake, early recovery of bowel function, early mobilization, and early discharge of patients without compromise in safety concerns after urogynecological surgery.