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220 Enhanced recovery after surgery is feasible, beneficial and should be the standard in major gynecological surgeries
  1. N Kugelman1,
  2. O Lavie1,
  3. N Cohen1,
  4. M Schmidt1,
  5. A Reuveni2,
  6. L Ostrovsky1,
  7. H Dabah1 and
  8. Y Segev1
  1. 1Carmel Medical Center, Obstetrics and Gynecology, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
  2. 2Carmel Medical Center, Anesthesiology, Haifa, Israel


Introduction/Background*Enhanced recovery after surgery (ERAS) protocols are evidence-based protocols designed to standardize medical care, improve outcomes, and lower health care costs. Our objective was to evaluate the implementation of the ERAS protocol, and its effect on recovery during the hospitalization period after gynecological laparotomy surgeries.

Methodology In this retrospective cohort study we compared demographic and clinical data of consecutive patients at a single institute who underwent open gynecological surgeries before (August 2017- December 2018) and after (January 2019- March 2020) the implementation of the ERAS protocol. Eighty women were included in each group.

Result(s)*The clinical and demographic characteristics were similar between the women operated before and after implementation of the ERAS protocol. Following implementation of the protocol, decreases were observed in post-surgical hospitalization (from 4.89±2.56 to 4.09±1.65 days; p=0.01), in patients reporting nausea symptoms (from 18 (22.5%) to 7 (8.8%); p=0.017), and in the use of postoperative opioids (from 77 (96.3%) to 47 (58.8%); p<0.001). No significant changes were identified between the two periods regarding vomiting, 30-day re-hospitalization and postoperative minor and major complications.

Abstract 220 Table 1

Comparison of postoperative ERAS protocol interventions before and after its implemention

Abstract 220 Table 2

Comparison of postoperative clinical outcomes before and after implementation of the ERAS protocol

Conclusion*Implementation of the ERAS protocol is feasible and was found to result in less postoperative opioid use, a faster return to normal feeding and a shorter postoperative hospital stay. Implementation of the protocol implementation was not associated with an increased rate of complications nor with re-admissions.

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