PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
Synapse
⌘+K
Synapse
December 27, 2021Archives of Gynecology and ObstetricsOpen Access

The impact of Enhanced Recovery after Surgery (ERAS) pathways with regard to perioperative outcome in patients with ovarian cancer

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Major surgery for ovarian cancer carries significant morbidity, and it was unknown whether implementing an ERAS protocol reduces postoperative complications during extensive cytoreductive surgery.

Does an Enhanced Recovery after Surgery (ERAS) protocol reduce postoperative complications and length of hospital stay in patients undergoing cytoreductive surgery for ovarian cancer?

Population

134 patients with ovarian cancer (FIGO I-IV)

Comparison

Mandatory ERAS protocol vs pre-ERAS care

Design

Prospective cohort study compared to historical controls

Key result

Implementation of a mandatory Enhanced Recovery after Surgery (ERAS) protocol significantly reduced postoperative complications (29.8% vs 52.9%) and length of hospital stay (11 vs 13 days) compared to historical controls.

Authors

SRSusanne ReuterLWLinn WoelberCTC. Trepte

Discussion

Loading...

Member takes

Overview

ERAS protocol was associated with fewer complications and shorter stays after ovarian cytoreduction; hypothesis-generating and requires RCTs before practice change.

Study Design

Type

Cohort (n=134)

Multicenter

No

Structured PICO

Does an Enhanced Recovery after Surgery (ERAS) protocol reduce postoperative complications and length of hospital stay in patients undergoing cytoreductive surgery for ovarian cancer?

P
Population
134 women with ovarian cancer undergoing cytoreductive surgery via laparotomy, comparing a prospective ERAS cohort to a historical control group.
I
Intervention
Mandatory Enhanced Recovery after Surgery (ERAS) protocol, including extended preoperative education, avoidance of bowel preparation, carbohydrate loading, early enteral feeding, early mobilization, and opioid-sparing pain therapy.
C
Comparator
Historical control group (pre-ERAS) treated with standard care between 2015 and 2017.
O
Outcome
Postoperative complications and length of stay in hospital.hard clinical

Main Result

Absolute Event Rate: 29.8% vs 52.9%

p-value: p=0.011

Implementation of a mandatory ERAS protocol in patients undergoing extensive cytoreductive surgery for ovarian cancer significantly reduces postoperative complications and length of hospital stay.

Limitations

  • Comparison to a historical control group, which cannot exclude time effects regarding treatment strategies.
  • Differences in surgical radicalness between groups, such as less frequent systemic radical lymphonodectomy in the ERAS group.
  • Higher POSSUM score in the ERAS group indicating a higher baseline surgical risk.
  • Comparison to a historical control group, meaning differences regarding outcome could be caused by time effects regarding treatment strategies.

Cite This Study

Reuter et al. (2021) conducted a cohort in Ovarian cancer (n=134). Enhanced Recovery after Surgery (ERAS) protocol vs. Standard care (historical pre-ERAS cohort) was evaluated on Total number of postoperative complications (p=0.011). Implementation of a mandatory Enhanced Recovery after Surgery (ERAS) protocol significantly reduced postoperative complications (29.8% vs 52.9%) and length of hospital stay (11 vs 13 days) compared to historical controls.

synapsesocial.com/papers/6a7b0fa677336a1bae030fa1https://doi.org/10.1007/s00404-021-06339-6
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Predictors of complications in gynaecological oncological surgery: a prospective multicentre study (UKGOSOC—UK gynaecological oncology surgical outcomes and complications)2014 · 66 citations
  2. 2POSSUM: A scoring system for surgical audit1991 · 1,727 citations
  3. 3Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center, prospective, randomized study2013 · 231 citations
  4. 4Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: A combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials2009 · 1,643 citations
  5. 5The effect of accelerated rehabilitation on recovery after surgery for ovarian malignancy2006 · 111 citations