Introduction/Background Enhanced recovery after surgery (ERAS) and prehabilitation programs are multidisciplinary care pathways that aim to optimize patients’ physical fitness prior to surgery and mitigate the detrimental effects of surgical stress, in order to improve recovery after surgery. This study aimed to assess the impact of introducing a prehabilitation and ERAS program for patients who were undergoing surgery for endometrial cancer on their post-operative outcomes.

Methodology In this prospective, single-center study we evaluate a cohort of consecutive patients undergoing surgery for endometrial cancer who followed a prehabilitation and ERAS program. Post-operative outcomes of these patients were compared to those of a retrospective cohort of patients who underwent surgery for endometrial cancer before the implementation of this program.

Results In total 307 patients were included: 35 patients that followed the ERAS-prehabilitation program and 272 patients who had surgery before the implementation of the program, between 2010–2018. There were no significant differences in clinic-demographic or tumor characteristics, neither in type of surgery performed between the study groups. In the ERAS-prehabilitation group, compliance rate exceeded 80% in all proposed pre-operative interventions, while compliance only exceeded 80% in 9 out of 15 intra-operative and 3 out of 7 post-operative interventions. The ERAS-prehabilitation group had shorter hospital-stay (3 vs. 4 days; p<0.001). There were no differences between groups regarding blood loss, need for blood transfusion, complication rate or need for reintervention.

Conclusion The implementation of an ERAS-prehabilitation program for patients undergoing surgery for endometrial cancer is feasible and highly accepted by patients, with high compliance rates to pre-operative interventions. Compliance rate to intra ant post-operative interventions is still suboptimal, highlining the need for training of health-care professionals involved in the care of these patients. Even with suboptimal compliance rates, a prehabilitation-ERAS program could significantly reduce hospital stay, without increasing the complication rate or need for reintervention.

Disclosures The authors have no conflicts of interest.