THE IMPLEMENTATION OF AN ERAS PROTOCOL IN GYNECOLOGICAL ONCOLOGY PATIENTS AT A SINGLE TERTIARY CARE CENTRE.

Abstract

Objectives The objective of the study is to determine if the implementation of an Early Recovery After Surgery (ERAS) protocol in gynecologic oncology patients undergoing a laparotomy for benign or malignant indications results in shorter length of post-operative hospital stays without increasing complication or readmission rates within a 30day post-operative period. Methods This is a retrospective cohort study with information being obtained from patient hospital charts. Using descriptive statistics, a comparison of the patient cohort prior to ERAS protocol implementation (all consecutive patients undergoing laparotomy by a gynecologic oncologist for benign or malignant indications at a tertiary care centre from Jan-Sept 2015 where standard post-operative care was followed) is made to the patient cohort that followed the ERAS protocol (all consecutive patients that underwent a laparotomy by a gynecologic oncologist for benign or malignant indications at the same tertiary care centre from Jan-Sept 2016). The primary outcomes of the study include length of post-operative hospital stay, complication rates and readmission rates within a 30-day post-operative period. Results The ERAS protocol cohort had shorter length of hospital stays (3.47vs. 3.78 days) (p=0.62), similar complication rates (28.5% vs. 24.4%) (p=0.44) and lower hospital readmission rates (10.6% vs. 12.4%) (p=0.72) within a 30day post-operative period in comparison to the non-ERAS cohort. Conclusions Implementation of an ERAS protocol in gynecologic oncology patients undergoing a laparotomy for benign ormalignant indications at a single tertiary care centre results in shorter length of hospital stays without increasing complication or readmission rates within a 30day post-operative period.