Outcomes of Enhanced Recovery after Surgery (ERAS) in Gynaecologic Oncology: A Randomized Clinical Trial

Articles in Press

Document Type : Research Articles

Authors

1 Department of Anaesthesiology, Hellenic Anticancer Institute, “Saint Savvas” Oncology Hospital of Athens, Greece.

2 Gynecologic Oncology Department, Hellenic Anticancer Institute, “Saint Savvas” Oncology Hospital of Athens, Greece.

3 Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Greece.

4 Department of Nursing, University of West Attica, Athens, Greece.

Abstract

Objective: ERAS protocols in major gynaecologic oncology surgery (MGOS), have established effectiveness in reducing complications, Length of Stay (LOS), and hospital costs. Their implementation appears to improve patient care compared to conventional perioperative practice. This study assessed the efficacy of ERAS protocol versus conventional postoperative care in the recovery of patients undergoing major gynaecological oncology surgery (MGOS). Methods: A prospective, randomized, single-centre study. A sample size of convenience  included 101 patients with gynaecological cancer  who underwent MGOS. Patients randomized into two groups: in group A (n=51, 50.5%), patients allocated to the ERAS protocol, and in group B (n=50, 49.5%), patients  followed conventional care. Results: The mean age in  group A was 52.8 years and in group B 56.7 years (p = 0.1). In the ERAS group the LOS  was  significantly lower compared to the control group, mean 3.9 versus 5.9 days (p < 0.001). All indicators of recovery, such as  mobilisation, feeding, bowel motility , discontinuation of intravenous (IV) administration, catheter and drainage removal in the first 24 hours, were significantly improved in patients in the ERAS group. Furthermore complications in patients in the ERAS group, such as fever, urinary tract infection, and perioperative bleeding, were also significantly lower.Conclusion: Within the limitations of a small single centre RCT, ERAS protocol in MGOS appeared to promote early enteral feeding, discontinuation of IV fluids, early gastrointestinal motility , faster removal of drainage and bladder catheter, faster patient standing and mobilisation, fewer requirements for blood transfusion, lower rate of drowsiness and sedation and episodes postoperative fever and leukocytosis. 

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Asian Pacific Journal of Cancer Prevention

Articles in Press, Accepted Manuscript
Available Online from 12 September 2025

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History

  • Receive Date: 04 January 2025
  • Revise Date: 01 June 2025
  • Accept Date: 07 September 2025

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