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46 The impact of an enhanced recovery after surgery (ERAS) protocol in patients undergoing abdominal hysterectomies in a teaching hospital
  1. V Alvarenga Bezerra1,
  2. G Marçal Rios1,
  3. AC Seixas Mengai1,
  4. C Amaral Tavares Daltro1,
  5. S Podgaec1,
  6. M Granado Barbosa2,
  7. M Tamura Vieira Gomes1,
  8. G Anderman Silva Barison1,
  9. F Rolla3,
  10. E Cristiane da Silva4,
  11. P Nicolau Ferreira Achê5,
  12. F Ferraz Assir6 and
  13. R Moretti Marques7
  1. 1Hospital Israelita Albert Einstein, Gynecology, São Paulo, Brazil
  2. 2Hospital Municipal Dr. Moyses Deutsch, Gynecologic Surgery, São Paulo, Brazil
  3. 3Hospital Municipal Dr Moyses Deustsch, Director, São paulo, Brazil
  4. 4Hospital Municipal Dr Moyses Deutsch, Gynecology Nurse, São Paulo, Brazil
  5. 5Hospital Municipal Dr. Moyses Deutsch, Anestesiology, São Paulo, Brazil
  6. 6Hospital Israelita Albert Einstein, Research Assistant, São Paulo, Brazil
  7. 7Hospital Israelita Albert Einstein, Gynecologic Oncology, São Paulo, Brazil


Objectives To implement and evaluate a protocol of care and rapid perioperativerecovery modified for gynecological surgery in Abdominal Hysterectomy at ateaching hospital, to mitigate the physiologic stress of surgery and optimize therehabilitation of patients.

Methods The modified ERAS protocol was implemented inthe Hospital Moyses Deutsch - Mboi Mirim, in partnership with Hospital IsraelitaAlbert Einstein. The study was divided into 3 phases: I. Retrospective data collectionof patients that went through Abdominal Hysterectomy with or without Salpingo -oophorectomy for benign disease, from March to December 2017 (N = 99); II.Training of the multiproffessional team for protocol implementation; III.Implementation of protocol in consecutive patients submitted also to AbdominalHysterectomy with or without Salpingo - oophorectomy for benign disease and itstarted in July 2018 (N = 58). Data were extracted from a database using Redcapplatform. Phase I and III data were compared with Student's t, Mann Whitney andchi-square tests.

Results The characteristics of the patients before and after ERASimplantation were statistically similar (p&gt; 0.05). There was success in theimplementation of the protocol, reaching statistically significance in reduction inlength of hospital stay (p<0.001), postoperative infection (p = 0.001), intraoperativecomplications (p = 0.027) without increase in postoperative complications orreadmission, and cost reduction (p<0.001).

Conclusions The implementation ofthe ERAS protocol in a teaching hospital in gynecological surgery reduceshospitalization time without increasing the rate of complications or re-hospitalization,and reduces the cost of the procedure.

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