Perioperative enhanced recovery programmes for women with gynaecological cancers

Chau, Janita Pak Chun; Liu, Xu; Lo, Suzanne Hoi Shan; Chien, Wai Tong; Hui, Sze Ki; Choi, Kai Chow; Zhao, Jie

doi:10.1002/14651858.cd008239.pub5

Cited by 11 publications

(8 citation statements)

References 87 publications

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“…Our reported improvements in postoperative complication rates and readmission rates align with findings previously reported by other surgical specialties with the implementation of ERAS [21]. Multiple metaanalyses found that enhanced recovery strategies reduced hospital stay [22,23]. However, there were few reports on the role of TU-LESS with the implementation of ERAS for the treatment of malignant diseases.…”

Section: Interpretation (In Light Of Other Evidence)supporting

confidence: 87%

Role of transumbilical laparoendoscopic single-site surgery in the implementation of ERAS in gynecology oncology: a retrospective study

Li¹,

Zheng²,

Yang³

et al. 2022

Preprint

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Objective: We accumulated the data to verify the fast recovery effect of transumbilical laparoendoscopic single-site surgery by analyzing the perioperative outcomes of patients with gynecological malignancies in the implementation of ERAS. Design: A retrospective study Setting: A university academic hospital Population or Sample: Patients with gynecological cancer undergoing transumbilical laparoendoscopic single-site surgery (TU-LESS) by a single experienced surgeon. Methods: This was a retrospective consecutive single-center study of patients with gynecological cancer undergoing TU-LESS from November 2017 and January 2022. Main Outcome Measures: The main outcomes were the perioperative outcomes in various surgeries including surgery time, estimated blood loss, length of hospital stay, and complications. Results: 315 gynecologic malignant cases successfully experienced TU-LESS in West China Second Hospital were incorporated, including 195 cervical cancers, 86 endometrial cancers and 34 ovarian cancers. The average age for patients is 47.48 (SD = 8.77). The average operating time and blood loss is 273.71 (SD = 87.12) minutes and 166.87 (SD = 237.09) ml, respectively. The average time for the first passage of flatus is 43.68 (SD = 29.75) hours. The hospitalization is 5.30 (SD = 2.42) days in average. Conclusions: TU-LESS is capable to enhance the recovery of patients who suffer from gynecological malignancies in the implementation of ERAS with less pain, shorter hospitalization and better rehabilitation. Funding: Science and Technology Program of Sichuan, China (2021YJ0137), Machine learning for risk warning and treatment guidance of preserving fertility in patients with endometrial cancer and endometrial atypical hyperplasia. Keywords: ERAS, TU-LESS, gynecology oncology

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Section: Interpretation (In Light Of Other Evidence)supporting

confidence: 87%

Role of transumbilical laparoendoscopic single-site surgery in the implementation of ERAS in gynecology oncology: a retrospective study

Li¹,

Zheng²,

Yang³

et al. 2022

Preprint

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“…Furthermore, previous studies have found a substantial difference in quality of life between the ERAS program and standard care, which indicates that ERAS is beneficial (71,72). There is also evidence that the LOS of patients treated with the ERAS program is shorter (73). This meta-analysis indicated significant heterogeneity among studies.…”

Section: Discussionmentioning

confidence: 73%

Outcomes of enhanced recovery after surgery in lung cancer: A systematic review and meta-analysis

Zhang

Qin

et al. 2022

Asia-Pacific Journal of Oncology Nursing

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“…Among health professionals, the reasons for even initial resistance to change were due to two main reasons which are largely confirmed: specific and time-rooted beliefs of healthcare professionals and the lack of knowledge of scientific evidence. On the other side, a recent review claimed the need for a higher evidence proving the advantages reported in the various studies published [36]. However, discussing ERAS in a study, a crossover effect is an import issue that is difficult to avoid, given the nature of the pragmatical and well recognizable care.…”

Section: What Type Of Barriers?mentioning

confidence: 99%

Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of Barriers

Forte¹,

Ferrari²,

Majd³

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Objectives:The advantages of the enhanced recovery after surgery (ERAS) protocols application in all surgical branches have been largely demonstrated, even though there is a lack of a strong evidence from randomized trial and the evidence regarding the multimodality treatments is of low grade. Moreover, the problem of the barriers to the implementation of these protocols in clinical practice remains an unsolved problem. Mechanism: We performed a narrative review reporting the main barriers and enablers on the subject. Finding in Brief: The main barriers are resistance to change, lack of support from institutions and of financial resources or manpower, poor communication and collaboration within the multidisciplinary team, organizational problems, lack of standardized protocols, patientrelated barriers (individual factors, reluctance, or inadequate education) and lastly clinical practice in small community hospitals. To overcome these problems, several enablers have been identified including: the involvement of the patient, the reorganization of care systems through standardized ERAS protocols, identification of a leader/coordinator, promotion of teamwork and staff education, financial resources, and the recognition of the role of the professionals involved. Conclusions: At this moment, resistance to change remains the most frequent and difficult barrier to overcome and, in our opinion, a reorganization of the health system aiming to the implementation of the ERAS protocols in the clinical practice is required.

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Perioperative enhanced recovery programmes for women with gynaecological cancers

Cited by 11 publications

References 87 publications

Role of transumbilical laparoendoscopic single-site surgery in the implementation of ERAS in gynecology oncology: a retrospective study

Role of transumbilical laparoendoscopic single-site surgery in the implementation of ERAS in gynecology oncology: a retrospective study

Outcomes of enhanced recovery after surgery in lung cancer: A systematic review and meta-analysis

Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of Barriers

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