Evaluation of the effectiveness of Enhanced Recovery After Surgery protocols in the treatment of gynecological patients with simultaneous surgical pathologies

The objective: to evaluate the effectiveness of Enhanced Recovery After Surgery (ERAS) protocols implementation in the treatment of gynecological patients who need the simultaneous surgical procedures and to compare the outcomes with traditional treatment methods.Materials and methods. The study included 151 patients who were divided into two groups: the control group (CG) – 92 patients after isolated gynecological surgeries, and the main group (MG) – 59 patients after simultaneous surgical interventions. All patients had plan operations according to the principles of rapid recovery surgery. In the postoperative period, the following parameters were assessed: duration of surgical intervention, number and structure of postoperative complications, duration of inpatient treatment, intensity of pain in the postoperative period (according to the visual analog scale (VAS)) and the readiness of patients for discharge at the time of discharge from the hospital (according to the Post-Transition Ready for Discharge Scale (PT-RDHS)). Statistical analysis methods, in particular, t-test and Pearson’s chi-square test, were used to assess differences between groups in the main clinical indicators.Results. It was found that the average duration of surgery was significantly longer in the MG (89.56 ± 7.52 min) compared to the CG (53.91 ±5.10 min), p < 0.05. Major postoperative complications were found only in the CG (1.51%), whereas the frequency of minor complications (nausea, vomiting, hematomas) was similar in both groups (about 20.00%). Postoperative pain assessment using the VAS after 12 hours was 2.63 ± 1.60 points in the CG and 2.97 ± 1.80 points – in the MG (p = 0.162), while after 24 hours – 1.40 ± 0.71 and 1.62 ± 0.81 points, respectively (p = 0.081). The average length of hospital stay was approximately 2 days in both groups (p = 0.532). Readiness for discharge according to the PT-RDHS scale was also similar (7.10 ± 0.32 points in the MG and 7.12 ± 0.34 points – in the CG (p = 0.719)), which confirms the effectiveness of ERAS protocols in reducing the duration of hospitalization.Conclusions. The study results indicate that the implementation of ERAS protocols in patients undergoing simultaneous gynecological surgeries is a safe and effective approach. The use of these principles facilitates rapid recovery, reduces the incidence of complications, and minimizes postoperative pain. The absence of significant differences between the groups in terms of postoperative pain levels, hospital stay duration, and discharge readiness confirms the feasibility of applying ERAS protocols in complex surgical procedures. However, further research is needed to evaluate long-term outcomes and possible additional benefits of this approach in gynecological surgery.