Srovnání protokolu Enhanced Recovery Protocol s konvenční péčí u pacientů podstupujících urogynekologickou operaci

ERAS v urogynekologické chirurgii

Abstrakt

Objective. The impact of ERAS protocol on postoperative outcomes after urogynecological surgery is yet to be a matter of investigation. This study sought to evaluate this issue by comparing the patients who had conventional or ERAS-guided perioperative care for several clinical end-points including ambulation, length of hospital stay (LOS), readmissions, and postoperative complications.

Materials and methods. A total of 121 patients undergoing pelvic organ prolapse surgery were allocated to two study arms; ERAS protocol (Group E) or conventional care (Group C). Variables reflecting the restoration of appetite and bowel movements, bleeding events, other complications, LOS, and readmissions were compared between the groups.

Results. The patients in Group C significantly received a more intensive intravenous fluid treatment as compared to Group E (ml, 2760 ± 656 vs. 1045 ± 218, p<0.001). Time required for first flatus, first defecation, eating solid food, and ambulation (p<0.001) were also longer in the former group of patients. Moreover, LOS was significantly reduced if the ERAS protocol was applied (days; 2.5 ± 1.1 vs. 2.0 ± 0.6, p<0.001). On the other hand, the two groups were similar with respect to the frequency of the postoperative complications, including surgical site infections, cardiovascular complications, non-specific abdominal pain, sub-ileus, blood loss, and readmission rate.

Conclusion. In our sample population, ERAS protocol led to early initiation of oral intake, early recovery of bowel function, early mobilization, and early discharge of the patients without a compromise in safety concerns after urogynecological surgery.