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Int J Gynecol Cancer. 2019 Mar 15. pii: ijgc-2019-000356. doi: 10.1136/ijgc-2019-000356. [Epub ahead of print]

Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations-2019 update.

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Division of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Anesthesia, Virginia Commonwealth University Hospital, Richmond, Virginia, USA.
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Division of Gynecologic Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Anesthesiology, Oak Hill Hospital, Brooksville, Florida, USA.
Departments of Surgery and Clinical Sciences, Ersta Hospital and Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Department of Surgery, Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.



This is the first updated Enhanced Recovery After Surgery (ERAS) Society guideline presenting a consensus for optimal perioperative care in gynecologic/oncology surgery.


A database search of publications using Embase and PubMed was performed. Studies on each item within the ERAS gynecologic/oncology protocol were selected with emphasis on meta-analyses, randomized controlled trials, and large prospective cohort studies. These studies were then reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.


All recommendations on ERAS protocol items are based on best available evidence. The level of evidence for each item is presented accordingly.


The updated evidence base and recommendation for items within the ERAS gynecologic/oncology perioperative care pathway are presented by the ERAS® Society in this consensus review.


Enhanced Recovery After Surger; intraoperative care; postoperative care; preoperative care; surgery


Conflict of interest statement

Competing interests: GN is the Secretary for the ERAS® Society. MS received honoraria for lecturing and travel expenses from Baxter Healthcare, Merck, and Deltex. He is an Executive Committee member of the ERAS® Society. AA has received speaker’s honoraria from Sanofi and AstraZeneca, and is on the Advisory Board of AstraZeneca. GM is a consultant for ConMed and Edwards Lifesciences and has stock options with Pacira Pharmaceutical. OL has an appointment with Nutricia Advisory Board, has given advice to MSD, Abbot and Advanced Medical Nutrition. He has received speaker’s honoraria from Nutricia, MSD, BBraun, Medtronic and Fresenius-Kabi. He is the current Chairman of the ERAS® Society. He founded, and owns stock in, Encare AB that runs the ERAS® Society Interactive Audit System (EIAS). SD is a member of the Board of Directors for ERAS® USA and a content expert for the AHRQ program for improving surgical care and recovery.

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