Key result
The ERAS protocol significantly increased the rate of discharge on day one to 92.3% compared to 26.9% with traditional care in patients undergoing laparoscopic hysterectomy.
Why the study?
Fast-track surgery in elective gynecologic laparoscopic surgery had not been well assessed and consensus guidelines were lacking.
Does the ERAS protocol reduce length of hospitalization and improve recovery in patients undergoing laparoscopic hysterectomy?
RCT (n=260)
Open-label
Block random allocation (1:1)
No
Does the ERAS protocol reduce length of hospitalization and improve recovery in patients undergoing laparoscopic hysterectomy?
The ERAS protocol is effective in reducing hospital stay and accelerating recovery in patients undergoing laparoscopic hysterectomy without increasing complications or pain.
This is the authors' abstract. We don't add key points for this paper.
Background & Objective: Fast-track surgery (FTS) consists of different pathways to decrease surgical complications and improve outcomes and patient satisfaction. FTS in an elective gynecologic laparoscopic surgery has not been well assessed. No consensus guidelines have been developed for gynecologic laparoscopic surgeries. The purpose of this study is to evaluate enhanced recovery after surgery (ERAS) for total laparoscopic hysterectomy.Materials & Methods: 260 patients underwent for laparoscopic hysterectomy surgery. All patients were divided into two groups as follows: one group received traditional laparoscopic hysterectomy surgery and the intervention group was treated under ERAS protocol. ERAS protocol includes not receiving preoperative mechanical bowel preparation and laxatives as well as fasting 6 h and not drinking liquids 2h before surgery. The patients were allowed to resume the ordinary diet 6h post-operation. Ondansetron 4 mg were prescribed after surgery for nausea and vomiting, pain was controlled with non-narcotic analgesics diclofenac suppository 100 mg/q12 h and paracetamol 1000 mg/q6 h until discharge. Urinary catheter was removed whenever possible and early ambulation occurred 6h after the surgery.Results: A total of 260 patients were studied. Regarding the length of hospitalization, significant differences were shown between the groups (P<0.001). Return to daily functions was occurred earlier in the fast-track surgery group than another group. Complications and VAS pain scores showed no significant differences between the groups.Conclusion: Our results show that ERAS surgery has fewer side effects and better outcomes which make it more suitable for patients undergoing laparoscopic hysterectomy.
Supports ERAS adoption in laparoscopic hysterectomy to shorten stays; extends prior surgical evidence to gynecologic procedures.
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Gharouni et al. (2022) conducted an RCT in Benign uterine disease requiring total laparoscopic hysterectomy (n=260). Enhanced Recovery After Surgery (ERAS) protocol vs. Traditional laparoscopic hysterectomy surgery protocol was evaluated on Discharge on day 1 (p=0.001). The ERAS protocol significantly increased the rate of discharge on day one to 92.3% compared to 26.9% with traditional care in patients undergoing laparoscopic hysterectomy.
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