A Full Enhanced Recovery after Surgery Program in Gynecologic Laparoscopic Procedures: A Randomized Controlled Trial

Area of Science:

• Gynecologic Surgery
• Perioperative Medicine
• Enhanced Recovery After Surgery (ERAS) Protocols

Background:

• Enhanced Recovery After Surgery (ERAS) programs aim to optimize patient recovery pathways.
• Limited ERAS protocols may not fully leverage the benefits of multimodal perioperative care.

Purpose of the Study:

• To evaluate if a full ERAS program offers superior perioperative outcomes compared to a limited ERAS approach in patients undergoing gynecologic laparoscopic surgery.

Main Methods:

• A randomized controlled trial involving 144 women undergoing elective gynecologic laparoscopic surgery.
• Patients were assigned to either a full ERAS intervention or a limited ERAS management group.
• Outcomes included postoperative length of stay, pain, recovery milestones, morbidity, and cost.

Main Results:

• The full ERAS group experienced a significant reduction in postoperative length of stay (1 day vs. 2 days, p=.001).
• Patients in the full ERAS program reported less pain, lower narcotic use, and better quality of recovery (p=.030).
• No significant differences were observed in 30-day morbidity, readmission rates, or in-hospital costs.

Conclusions:

• Implementing a full ERAS program can further decrease postoperative length of stay after gynecologic laparoscopic procedures.
• Comprehensive ERAS management improves patient quality of life and recovery following gynecologic surgery.