Introduction/Background*Open approach has become the standard for many institutions when performing a radical hysterectomy for early cervical cancer. The objective of this study was to evaluate the length of stay after open radical hysterectomy before and after the implementation of Enhanced Recovery After Surgery (ERAS) pathway in a tertiary cancer center.

Methodology This is a retrospective study of patients who underwent open radical hysterectomy for cervical cancer from January 2009 to December 2020. We distinguished two groups based on the time of ERAS implementation: group 1 (pre-ERAS) between January 2009 and October 2014 and group 2 (post-ERAS) between November 2014 and December 2020. We also defined two time periods according to the application of open radical hysterectomy as a standard of care. Univariate analysis was applied and P values were reported using chi-squared or Fisher’s exact test.

Result(s)*A total of 81 patients were included; 29 patients in group 1 and 52 patients in group 2. There were no differences in terms of age (median of 42 years [35-53] in group 1 vs 41 years [35-49] in group 2; p=0.47) and BMI (26.1 kg/m² [24.6-29.7-53] in group 1 vs 27.1 in kg/m²[23.5-33.5] in group 2; p=0.44). Patients in group 2 were discharged from the hospital earlier compared to group 1 (median 3 days [2-3] vs 4 days [3-5], p<0.01). There were no differences regarding overall complications (38.5%, group 1 vs 44.8%, group 2; p=0.57) and readmission rates within 30 days (1.9%, group 1 vs 10.3%, group 2; p=0.05). When analyzing the two periods in relation to change of institutional practice to exclusively open approach (November 2017-December 2020), the length of stay was also shorter (median 3 days [2-3] vs 3 days [3-4], p<0.01). Adherence to ERAS pathway remained stable to date with a median of 70% [IQR 65-75%].

Conclusion*Patients undergoing an open radical hysterectomy under an ERAS pathway have a decreased length of hospital stay without increasing overall complications nor readmissions rate.