Title : Enhanced recovery after surgery (ERAS) pathways for patients undergoing elective gynecologic oncologic surgeries
Abstract:
Multimodal interventions under a single perioperative program, known as Enhanced Recovery After Surgery (ERAS), have been shown to reduce physiological stress and organ dysfunction associated with surgery. ERAS pathways aim to reduce the catabolic effects of surgery and anesthesia, thereby minimizing postoperative complications, shortening hospital stays, and lowering healthcare costs. Involving patients at every step of the process from decision-making to discharge is fundamental to ERAS. The purpose of this study was to evaluate the impact of ERAS implementation on the outcomes of gynecologic-oncologic surgeries. A randomized prospective observational study was conducted on 200 patients aged 18-70 years, with ASA physical status I-II, excluding those with uncontrolled diabetes or systemic disease. Patients were randomly assigned to two groups: the ERAS group (100 patients) and the control group (100 patients). The ERAS group received 200 ml of carbohydrate drink 2 hours before surgery, followed by standard anesthesia and perioperative care, including normothermia maintenance, restricted intraoperative fluid management, early enteral feeding, and early mobilization within 24 hours. The control group received care per institutional protocols. The results showed no significant difference in age, weight, ASA status, or surgery duration between groups. However, the ERAS group had a significantly shorter hospital stay (p < 0.001). Additionally, vital parameters, including heart rate, blood pressure, oxygen saturation, and glucose levels, showed significant improvement in the ERAS group compared to controls. Early mobilization and feeding were also significantly improved in the ERAS group (p < 0.001). There were no significant differences in nausea or vomiting between groups. In conclusion, ERAS protocols reduce hypothermia, hyperglycemia, and postoperative complications, promoting early recovery and reducing hospital stay, ultimately lowering overall healthcare costs.
Keywords: Enhanced recovery after surgery (ERAS), Gynecologic Oncologic Surgery, Early Mobilization, Postoperative Recovery, Healthcare Costs.
