Introduction/Background To study the impact of modified Enhanced Recovery After Surgery (ERAS) program for endometrial carcinoma, on the perioperative outcome.
Methodology The study included females with physical status I and II according to American Society of Anesthesiologists (ASA) undergoing exploration for endometrial carcinoma. ECOG Performance Status was used to determine patient’s disease progression. The study was done in El-Salam Oncology center; Cairo and Minia Maternity University Hospital, Egypt. The study included two groups of patients diagnosed as endometrial carcinoma prepared for surgical management. First group included patients prepared for laparoscopy (n=27) and was managed with ERAS protocol. Another group prepared for laparotomy (n=31) and was managed with conventional protocol.
Results The length of hospital stay (LOS) was reduced in ERAS group when compared with the control group (1.77±1.13 days compared with 6.13±2.25 days; P<0.0001; CI 3.4013 to 5.3187). Opioid use was reduced in ERAS group compared to the control group (1.10±0.41 mg and 9.83±3.6 mg; P<0.0001) and postoperative fluid use was also less in the ERAS group compared to the control group (1362.9±234.3 ml compared with 2303.2±512 ml; P<0.0001; CI 725.4990 to 1155.1010). Pain score using VAS on postoperative day 0 was 3.18±1.15 vs 4.48±1.68 (P=0.0013) for both active and control groups respectively.
Conclusion Implementation of ERAS protocols in gynecologic surgery for endometrial carcinoma should be tailored according to the situation of each case. But in general, ERAS was associated with significant reduction in length of hospital stay, reduction in the operative time and blood loss, associated with controlled intravenous fluids utilized and comparable pain control to conventional protocols with improvement in complication rates.
Disclosure Nothing to disclose.
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