Introduction/Background Enhanced recovery after surgery (ERAS) and prehabilitation programs are multidisciplinary interventions that aim to optimize the physical condition of patients prior to surgery. These programs improve postoperative recovery and reduce the impact of surgical interventions. In this study, we aimed to assess the compliance of patients and healthcare professionals to an ERAS-prehabilitation program at our gynecologic-oncology and investigate whether higher compliance rates were associated with improved postoperative outcomes.
Methodology From February 2018 to June 2020, patients undergoing surgery for gynecologic cancer were invited to participate in an ERAS-prehabilitation program, which included an initial assessment of patients‘ nutritional, cognitive, emotional, and functional status. Different interventions were proposed based on the patients‘ main needs to improve their fitness. Patients were followed up with weekly calls and a post-intervention assessment 28 days after starting the program. Intra and postoperative interventions were also proposed to mitigate surgical stress and speed recovery. Compliance with both preoperative and intra/postoperative interventions was described. The impact of a compliance rate >80% on postoperative outcomes was assessed.
Results 81 patients with a mean age of 70.2 years were prospectively included. Compliance was >80% in all preoperative interventions, in 8 out of 15 intraoperative interventions, and in 3 out of 7 postoperative interventions. Patients with a compliance rate >80% had a non-significant trend towards a shorter hospital stay compared to patients with a lower compliance rate (3 vs.5 days, p=0.356). A compliance rate >80% had no impact on complication or reintervention rates.
Conclusion an ERAS-prehabilitation program for patients undergoing surgery for gynecologic cancer is highly accepted by patients, with high compliance rates for preoperative interventions. However, compliance rates for intra and postoperative interventions still need improvement. While a compliance rate >80% did not have a significant impact on complication rates, it could lead to earlier discharge of patients.
Disclosures Conflicts of interest: none.
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