Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Pandraklakis Anastasios
Dissertation committee:
Νικόλαος Θωμάκος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αλέξανδρος Ροδολάκης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Δασκαλάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠA
Αθανάσιος Πρωτόπαππας, Καθηγητής, Ιατρική Σχολή, ΕΚΠA
Πέτρος Δρακάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠA
Δημήτριος Χαϊδόπουλoς, Αναπληρωτής Καθηγητής, Iατρική Σχολή, ΕΚΠA
Θεόδωρος Πανοσκάλτσης, Επίκουρος Καθηγητής, Iατρική Σχολή, ΕΚΠA
Original Title:
Εξειδικευμένη περιεγχειρητική φροντίδα και ταχεία μετεγχειρητική ανάρρωση στη Γυναικολογική Ογκολογία (ERAS pathways, Enhanced Recovery After Surgery). Η επίδραση στο χρόνο παραμονής στο νοσοκομείο, στις μετεγχειρητικές επιπλοκές, στις επανεισαγωγές και στο συνολικό κόστος νοσηλείας
Translated title:
Specialized perioperative care and rapid postoperative recovery in Gynecologic Oncology (ERAS pathways, Enhanced Recovery After Surgery). The effect on hospital length of stay, postoperative complications, readmissions and total hospital costs
Summary:
Objective: The aim of this study is to evaluate the effectiveness of the implementation of enhanced recovery after surgery (ERAS) protocols in gynecologic oncology patients who have undergone laparotomy for suspected or confirmed gynecologic malignancy.
Methods: From January 2020 to December 2021, we performed a prospective cohort study including patients who underwent laparotomy for suspected or confirmed gynecological malignancy and were managed according to the department's ERAS perioperative protocol. We retrospectively compared the perioperative results of the application of the protocol by collecting data from a similar number of patients who were operated on for the same indication just before the application of the ERAS protocols. The study took place in the division of Gynecologi Oncology of the 1st Department of Obstetrics and Gynecology of the National and Kapodistrian University of Athens, at Alexandra Hospital. Patients were followed up to 30 days after discharge. The main outcomes were length of hospital stay, rates of complications, reoperations, readmissions and mortality.
Results: We evaluated 300 patients before and 287 after the implementation of ERAS protocols. Mean compliance with ERAS elements increased from 21.2% to 85.1% after implementation (p< 0.001). The median length of stay for all surgeries decreased from 5.5 days to 4.0 days after ERAS (p < 0.001). Overall postoperative complications in the first 30 days decreased from 55% to 38.3% after ERAS (p < 0.001) without a statistically significant reduction in grade III-IV complications (6.7% to 3.1%, p= 0.078). There was also no significant difference in readmission (p = 0.65) and mortality (p = 0.166) rates between the two groups.
Conclusion Implementation of the ERAS program is feasible and safe in Gynecologic Oncology. In this study, after the implementation of the protocols there was a reduction of 1.64 days (p < 0.001) in the total hospitalization time, a reduction in the overall rate of complications by 16.7% (p < 0.001) without a statistically significant reduction in the rates of reoperations (p = 0.065) , readmissions (p = 0.461) and mortality (p = 0.166) postoperatively.
Main subject category:
Health Sciences
Keywords:
ERAS, Enhanced Recovery After Surgery, Gynaecologic, Oncology
Number of references:
392
