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J Minim Invasive Gynecol. 2019 Feb;26(2):327-343. doi: 10.1016/j.jmig.2018.12.010. Epub 2018 Dec 20.

Enhanced Recovery after Surgery in Gynecology: A Review of the Literature.

Author information

1
Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, New Orleans, Louisiana (all authors).. Electronic address: stacey@scheib.com.
2
Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, New Orleans, Louisiana (all authors).

Abstract

Enhanced recovery after surgery (ERAS), or "fast-track" protocol, aims to minimize the physiologic stress of surgery and optimize the rehabilitation of patients. However, there is limited data in obstetrics and gynecology. We reviewed the published literature on ERAS programs in gynecology to evaluate the outcomes and potential key elements for a successful program. Fifty studies were evaluated. We recommend preoperative counseling to the patient, no bowel preparation, an opioid-sparing multimodal approach to pain management, goal-directed fluid management, minimally invasive surgery when possible, and early mobilization and feeding. This is a multidisciplinary team effort and requires active patient participation in the process.

KEYWORDS:

ERAS; Enhanced recovery; Fast track; Gynecologic surgery; Gynecology; Same-day surgery

PMID:
30580100
DOI:
10.1016/j.jmig.2018.12.010

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