Enhanced Recovery after Surgery (ERAS) Protocol for Early Discharge within 12 Hours after Robotic Radical...

Area of Science:

• Gynecologic Oncology
• Minimally Invasive Surgery
• Surgical Outcomes Research

Background:

• Robotic radical hysterectomy (RRH) is a standard treatment for cervical cancer.
• Enhanced Recovery After Surgery (ERAS) protocols aim to optimize patient recovery and reduce hospital stays.
• The safety and feasibility of early discharge (ED) post-RRH within ERAS protocols require evaluation.

Purpose of the Study:

• To assess the safety of early discharge (≤12 hours) after RRH in cervical cancer patients within an ERAS protocol.
• To identify factors associated with early discharge and compare outcomes between early and late discharge groups.

Main Methods:

• Retrospective analysis of 94 consecutive cervical cancer patients undergoing RRH.
• Patients categorized into early discharge (ED; ≤12 hours) and late discharge (LD; >12 hours) groups.
• Comparison of operative outcomes, urinary catheter duration, blood loss, voiding difficulties, and unexpected visits.

Main Results:

• 77% of patients (n=72) were discharged within 12 hours.
• The ED group showed significantly shorter urinary catheter duration, less blood loss, and fewer voiding difficulties.
• No significant differences in perioperative complications or unexpected visits between ED and LD groups.
• Nerve-sparing (NS) RRH was the sole independent predictor for ED (p=0.043).

Conclusions:

• Early discharge within 12 hours after RRH is safe and feasible in the context of ERAS protocols.
• Nerve-sparing RRH is associated with improved genitourinary function recovery, enabling earlier discharge.
• Early discharge following NS-RRH within an ERAS pathway is a reasonable clinical strategy.