TY - JOUR T1 - Enhanced Recovery After Surgery (ERAS) in gynecologic oncology: an international survey of peri-operative practice JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer DO - 10.1136/ijgc-2020-001683 SP - ijgc-2020-001683 AU - Geetu Prakash Bhandoria AU - Prashant Bhandarkar AU - Vijay Ahuja AU - Amita Maheshwari AU - Rupinder K Sekhon AU - Murat Gultekin AU - Ali Ayhan AU - Fuat Demirkiran AU - Ilker Kahramanoglu AU - Yee-Loi Louise Wan AU - Pawel Knapp AU - Jakub Dobroch AU - Andrzej ZmaczyƄski AU - Robert Jach AU - Gregg Nelson Y1 - 2020/08/04 UR - http://ijgc.bmj.com/content/early/2020/08/03/ijgc-2020-001683.abstract N2 - Introduction Enhanced Recovery After Surgery (ERAS) programs have been shown to improve clinical outcomes in gynecologic oncology, with the majority of published reports originating from a small number of specialized centers. It is unclear to what degree ERAS is implemented in hospitals globally. This international survey investigated the status of ERAS protocol implementation in open gynecologic oncology surgery to provide a worldwide perspective on peri-operative practice patterns.Methods Requests to participate in an online survey of ERAS practices were distributed via social media (WhatsApp, Twitter, and Social Link). The survey was active between January 15 and March 15, 2020. Additionally, four national gynecologic oncology societies agreed to distribute the study among their members. Respondents were requested to answer a 17-item questionnaire about their ERAS practice preferences in the pre-, intra-, and post-operative periods.Results Data from 454 respondents representing 62 countries were analyzed. Overall, 37% reported that ERAS was implemented at their institution. The regional distribution was: Europe 61%, Americas 53%, Asia 30%, and Africa 17%. ERAS gynecologic oncology guidelines were well adhered to (>80%) in the domains of deep vein thrombosis prophylaxis, early removal of urinary catheter after surgery, and early introduction of ambulation. Areas with poor adherence to the guidelines included the use of bowel preparation, adoption of modern fasting guidelines, carbohydrate loading, use of nasogastric tubes and peritoneal drains, intra-operative temperature monitoring, and early feeding.Conclusion This international survey of ERAS in open gynecologic oncology surgery shows that, while some practices are consistent with guideline recommendations, many practices contradict the established evidence. Efforts are required to decrease the variation in peri-operative care that exists in order to improve clinical outcomes for patients with gynecologic cancer globally. ER -