RT Journal Article
SR Electronic
T1 Enhanced Recovery After Surgery for Suspected Ovarian Malignancy: A Survey of Perioperative Practice Among Gynecologic Oncologists in Australia and New Zealand to Inform a Clinical Trial
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 1046
OP 1050
DO 10.1097/IGC.0000000000000982
VO 27
IS 5
A1 Lindemann, Kristina
A1 Kok, Peey-Sei
A1 Stockler, Martin
A1 Sykes, Peter
A1 Brand, Alison
YR 2017
UL http://ijgc.bmj.com/content/27/5/1046.abstract
AB Objectives The objective of this survey was to review the current standard of perioperative care of patients with suspected advanced ovarian cancer in Australia and New Zealand in order to determine the level of equipoise for specific interventions.Methods In May 2016, a web-based questionnaire (SurveyMonkey Inc, Palo Alto, CA) was sent to all gynecologic oncologists in Australia and New Zealand (n = 56). Descriptive statistics were used.Results Response rate was 75%. Prevention of hypothermia, extended thromboembolic prophylaxis, antibiotic prophylaxis, and the avoidance of the routine use of drains were standard of care. Bowel preparation was given by 10% routinely and by 35% when bowel resection was planned. Fasting times for fluids of six hours or more were common (55%). Only 26% had shortened fasting times of two hours. Twelve percent used carbohydrate loading. The majority of patients started a light diet within the first postoperative day and advanced diet subsequently as tolerated. Six respondents (15%) used thoracic epidural, whereas the majority (73%) administered an opioid-based intravenous patient-controlled analgesia as the predominant postoperative analgesia, mainly as part of a multimodal pain management. The majority of respondents expressed an interest in a trial concept of individual ERAS interventions.Conclusions Only a minority of ERAS interventions can be considered standard of care in ovarian cancer surgery. The existing level of equipoise among gynecologic oncologists in Australia and New Zealand, and their interest in a trial concept of individual ERAS interventions allows further assessment of the feasibility and efficacy of interventions in a randomized controlled trial.