Introduction/Background The aim of this study is to present our experience and to evaluate the safety and the outcomes of the implementation of Enhanced Recovery After Surgery (ERAS) protocols in obese patients who underwent surgery for suspected or confirmed gynecological malignancies.

Methodology From January 2020 to September 2021, 217 patients underwent laparotomy for a confirmed or suspected gynecological malignancy following a 19-element ERAS pathway. The patients were divided in two groups: Obese (Body Mass Index (BMI) ≥ 30 kg/m2, n=104) and non-obese (BMI<30, n=113). Both groups were treated with a 19-element ERAS protocol.

Results After dividing the 217 patients in two groups, significantly more comorbidities were observed in the obese group (diabetes mellitus 23% vs 8%, p=0.004; ASA score grade 3, 25.0% vs 6.2%, p<0.001),as well as higher rates of endometrial cancer (51.9% 17.7%, p<0.001) compared to the non-obese group. The overall ERAS compliance rates when matched element-by-element were similar. Postoperatively, complication rates of all grades were significantly higher in the obese group (46.1% vs 27.4%, p<0.001) without differences in the length of stay, readmission and reoperation rates.

Conclusion In this retrospective study, we showed that obese gynecological oncology patients can be safely managed with ERAS protocols perioperatively, while potentially minimizing the adverse outcomes in these otherwise high-risk patients.

Disclosures The authors have nothing to disclose.