Enhanced Recovery after Laparoscopic Hysterectomy: A Real World Experience Adopting Eras in a Tertiary Gynecology Unit

Chatterjee U1*, Qian H2, Chua S1,3,4,5, Gibbs E6, Anpalagan A1,4 and Kapurubandara S1,4,7

1Department of Obstetrics and Gynecology, Westmead Hospital, Sydney, New South Wales, Australia
2Western Sydney Local Health District, Australia
3W2IRED, Westmead Women’s Institute of Research and Data Collaboration, Australia
4Sydney West Area Pelvic Surgery, Australia
5Western Sydney University, Australia
6NHMRC CTC University of Sydney, Australia
7University of Sydney, Australia

^*Correspondance to: Ushmi Chatterjee 

 PDF  Full Text DOI: 10.25107/2474-1647.3414

Abstract

Objective: To compare LOS and adverse outcomes between ERAS and conventional surgical models of care in gynecological patients at a single tertiary unit. Design: A three-year retrospective study was performed comparing the ERAS and conventional models on all patients undergoing Laparoscopic Hysterectomy (LH). Materials and Methods: Data was collected from the patients’ medical records. Data collected included baseline demographics, preoperative education, type and duration of surgery, postoperative analgesia, aperients and antiemetics used, use of postoperative drains, duration of indwelling catheter, LOS, and complications and readmissions within two weeks of discharge. Results: Sixty four patients in the ERAS cohort and 179 patients in the conventional cohort were analyzed. There were noticeable differences in patient demographics including median age (55 vs. 46 (p<0.001)), BMI, and country of birth (64% vs. 36% born in Australia (p=0.001)). Median LOS in the ERAS cohort was 2 h shorter (54 h vs. 56 h (p=0.009) and was associated with significant decrease in cumulative analgesia use. Country of birth, age, and malignant histopathology were all independent risk factors for increased LOS. There was no significant difference in readmission rates or complications between both cohorts. Conclusion: The use of ERAS protocol in gynecological patients was associated with a decrease in LOS and significant reduction in postoperative analgesia and no difference in readmission rates or complications. This study demonstrates widespread dissemination of ERAS principles despite implementation to only a select group of patients, highlighting a pragmatic approach to ERAS adoption.

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Cite the article

Chatterjee U, Qian H, Chua S, Gibbs E, Anpalagan A, Kapurubandara S. Enhanced Recovery after Laparoscopic Hysterectomy: A Real World Experience Adopting Eras in a Tertiary Gynecology Unit. Clin Surg. 2022; 7: 3414.