Author: Akhmetova Aigerim
Editor: Merentsova Anastasia
Enhanced recovery after surgery (ERAS), provides for a set of pre- and postoperative measures aimed at accelerating the rehabilitation of patients and reducing the length of hospitalization after planned surgical interventions. From the very beginning, the ERAS guidelines were developed for operations on the gastrointestinal tract and urinary tract. Their advantages have been proven more than once, and currently protocols are being introduced for reconstructive, thoracic, hepatobiliary, as well as surgery in the field of gynecology.
Let us consider the "mechanism" of the ERAS recommendations using the example of patients with anemia. The presence of anemia in patients is associated with higher rates of postoperative mortality, and therefore, in addition to diagnostics, the most effective correction is required at the stage of preparation for surgery. According to the data of the Cochrane database, an increase in the rate of recurrence of the tumor process after preoperative blood transfusion was proved; therefore, transfusion of blood components before surgery is not recommended, since it is associated with a less favorable prognosis for patients with cancer.
An Italian randomized trial provides Level I evidence supporting the efficacy of ERAS in the surgery of gynecological patients. Compared to standard preoperative preparation, women in the ERAS group had a shorter recovery period after surgery (2 days faster), 15% fewer postoperative complications and improved satisfaction with the quality of services at discharge (based on a questionnaire).
An Italian study provides Level I evidence to support the claim that ERAS is associated with improved outcomes and should be considered the standard of patient care during preoperative gynecological surgery.
Source: https://pubmed.ncbi.nlm.nih.gov/32977904/
