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Original research
Prehabilitation in an ERAS program for endometrial cancer patients: impact on post-operative recovery
  1. Ester Miralpeix1,
  2. Berta Fabregó1,
  3. Cristina Rodriguez-Cosmen2,
  4. Josep-Maria Solé-Sedeño1,
  5. Sonia Gayete1,
  6. David Jara-Bogunya3,
  7. Marta Corcoy2 and
  8. Gemma Mancebo1
  1. 1 Department of Obstetrics and Gynecology, Hospital del Mar, Barcelona, Catalunya, Spain
  2. 2 Department of Anesthesia, Hospital del Mar, Barcelona, Catalunya, Spain
  3. 3 Family and Community Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Catalunya, Spain
  1. Correspondence to Ester Miralpeix, Obstetrics and Gynecology, Hospital del Mar, Barcelona 08003, Spain; ester.miralpeix{at}gmail.com

Abstract

Objectives Enhanced recovery after surgery (ERAS) and prehabilitation programs are multidisciplinary care pathways that aim to reduce stress response and improve perioperative outcomes. However, literature is limited regarding the impact of ERAS and prehabilitation in gynecologic oncology surgery. The aim of this study was to assess the impact of implementing an ERAS and prehabilitation program on post-operative outcomes of endometrial cancer patients undergoing laparoscopic surgery.

Methods We evaluated consecutive patients undergoing laparoscopy for endometrial cancer that followed ERAS and the prehabilitation program at a single center. A pre-intervention cohort that followed the ERAS program alone was identified. The primary outcome was length of stay, and secondary outcomes were normal oral diet restart, post-operative complications and readmissions.

Results A total of 128 patients were included: 60 patients in the ERAS group and 68 patients in the prehabilitation group. The prehabilitation group had a shorter length of hospital stay of 1 day (p<0.001) and earlier normal oral diet restart of 3.6 hours (p=0.005) in comparison with the ERAS group. The rate of post-operative complications (5% in the ERAS group and 7.4% in the prehabilitation group, p=0.58) and readmissions (1.7% in the ERAS group and 2.9% in the prehabilitation group, p=0.63) were similar between groups.

Conclusions The integration of ERAS and a prehabilitation program in endometrial cancer patients undergoing laparoscopy significantly reduced hospital stay and time to first oral diet as compared with ERAS alone, without increasing overall complications or the readmissions rate.

  • endometrial neoplasms
  • laparoscopes

Data availability statement

Data are available upon reasonable request. Data are available in an SPSS format.

https://doi.org/10.1136/ijgc-2022-004130

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    Data availability statement

    Data are available upon reasonable request. Data are available in an SPSS format.

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    Footnotes

    • Twitter @solesedeno, @twigem2a

    • Contributors Study concepts: EM, GM, CR-C; Study design: EM, J-MS-S, GM, CR-C; Data acquisition: BF, EM, SG, DJ-B; Quality control of data and algorithms: BF, MC; Data analysis and interpretation: EM, GM, J-MS-S, SG; Statistical analysis: EM; Manuscript preparation: EM, BF, GM; Manuscript editing: CR-C, BF; Manuscript review: EM, J-MS-S, CR-C, BF, GM; All authors read and approved the final manuscript. GM: guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • © IGCS and ESGO 2023. No commercial re-use. See rights and permissions. Published by BMJ.