Enhanced recovery after gynecologic surgery: review of the literature

Abstract

Enhanced recovery after gynecologic surgery: review of the literature Mujde Can Ibanoglu1,*, Tugba Kinay1 , Yaprak Engin-Ustun1 1Department of Obstetrics and Gynecology, Ankara Etlik Zubeyde Hanım Women’s Health Training and Research Hospital, 06010 Ankara, Turkey *Correspondence: drmujdecan@gmail.com (Mujde Can Ibanoglu) Academic Editor: Donatella Caserta Submitted: 26 March 2021 Revised: 30 May 2021 Accepted: 2 June 2021 Published: 11 February 2022 Abstract Objective: Enhanced Recovery After Surgery (ERAS) includes practices aimed at providing rapid recovery by standardizing pre-and post-surgical care in patients undergoing colon surgery and reducing the metabolic stress response. The ERAS program is a systematic application that includes surgeons, anesthetists, nurses, and assistant healthcare professionals in the care process and has been successfully implemented in the international arena. Studies on ERAS protocols show that this system can be actively applied in different surgical areas. Mechanism: This review article discusses the main reviews and recommendations of the medical community on ERAS and valuable publications in the literature. Findings in brief: Guidelines of the ERAS Society for peri-operative care in gynecological procedures were first published in 2016 and updated in 2019. ERAS Society recommended 12 items for pre-and intra-operative care and 10 post-operative care items. The objectives of these applications are to provide patient education and consultancy services before surgery, to stop oral intake shortly before surgery and to start fast nutrition after surgery, to maintain a balanced body temperature and fluid level to maintain normal physiology, to increase mobilization, to provide pain control with painkillers, prophylaxis of nausea and vomiting and reduction of unnecessary or prolonged use of catheters. Conclusions: Studies suggest that increased compliance with ERAS agents in colon surgery has a positive effect on operation results, but more studies are needed to reach this affirmation in gynecological surgery. Keywords: Enhanced recovery; Gynecology; Perioperative care; Surgery