The authors report no conflicts of interest.
Running head: ERAS in Gynaecologic Laparoscopic Surgery
Meeting Presentation: A portion of the results from this study
was presented at the ERAS® Asia Congress 2019, September 27–28, 2019,
Singapore.
ObjectiveTo assess whether a full enhanced recovery after surgery
(ERAS) program can further reduce
perioperative outcomes among patients undergoing gynaecologic
laparoscopic procedures relative to those undergoing limited ERAS
management.
Design Single-center, open-label, randomized trial.
Setting A tertiary hospital, China: December 2018 to October
2019.
Population One hundred and forty-four women scheduled for an
elective simple gynaecologic laparoscopic surgery.
Methods Patients were randomized into two groups:
full ERAS intervention or limited
ERAS management.
Primary outcome Postoperative length of stay (LOS).
Results Postoperative LOS for the full ERAS program showed a
1-day reduction in comparison to the limited ERAS group (median of 1.0
day versus 2.0 days, respectively; P = .002). Multivariate
regression analysis identified preoperative carbohydrate loading and
opioid-sparing analgesia as the independent factors for discharging on
postoperative day (POD) 1. Patients in the full ERAS program reported
less postoperative pain within 72 hours postoperatively and had a lower
narcotic consumption rate compared with those in the limited ERAS
management. They also enjoyed better and faster recovery as demonstrated
by the QoR-15 scale on POD 3: median of 137.0 for full ERAS program
versus 130.0 for limited ERAS management, respectively (P =
.020). There were no significant differences between groups regarding
postoperative complication rate, readmission rate, or in-hospital cost.
Conclusion The addition of
full ERAS management can further reduce postoperative length of stay and
improve patients’ quality of life after laparoscopic surgery for
gynaecologic diseases.
Funding Statement This was a self-financing study and there are
no financial interests to report.
Keywords enhanced recovery after surgery, perioperative
management, gynaecologic laparoscopic surgery, length of stay.
Tweetable abstract A full enhanced recovery program can further
improve perioperative outcomes in gynaecologic laparoscopic procedures
compared with limited enhanced recovery management.
Clinical trial registration Chinese Clinical Trial Registry,
www.chictr.org.cn, ChiCTR1800019066.