Open surgery has become the standard technique for radical hysterectomy (International Federation of Gynecology and Obstetrics (FIGO) 2018 IA1 with lymphovascular space invasion-IIA1). The goal of the study was to evaluate the length of stay in women getting open radical hysterectomy before and after the implementation of an enhanced recovery after surgery (ERAS) program. This was a single-center, prospective before-and-after study of women who had an open radical hysterectomy for cervical cancer from January 2009 through December 2020. The researchers identified two groups based on when ERAS was implemented: pre-ERAS patients were those who had surgery between January 2009 and October 2014, while post-ERAS patients were people who had surgery between November 2014 and December 2020. Of the 101 patients who completed the questionnaire, there were 81 participants in the pre-ERAS group and 29 persons in the post-ERAS group. Both groups had similar clinical characteristics with no differences in terms of median age (42 years (interquartile range (IQR) 35–53) in the pre-ERAS group vs 41 years (IQR 35–49) in the post-ERAS group; P=0.47) and body mass index (26.1 kg/m2 (IQR 24.6–29.7) in pre-ERAS group vs 27.1 kg/m2 (IQR 23.5–33.5) in the post-ERAS group; P=0.44). The median time of post-ERAS patients’ hospital discharge was 3 days (IQR 2–3) shorter than the pre-ERAS group (median 4 days vs 4, P=0.01). The proportion of patients discharged within 48 hours was significantly higher in the post-ERAS group (47.3% vs 17.3%, P=0.013). There were no significant differences in overall complications (44.8% pre-ERAS vs 38.5% post-ERAS; p=0.57) or readmission rates within 30 days (20.7% pre-ERAS group vs 17.3% ERAS group; p=0.40) between the groups at 12. Following the ERAS approach since its implementation in 2014, adherence has remained consistent at around 70%, with a mean of 65% (IQR 65%–75%). Patients who received open radical hysterectomy on an ERAS path have a shorter length of hospital stay without increasing overall complications or readmissions rates.
Source:ijgc.bmj.com/content/32/4/480
