Many subfields of surgery now consider Enhanced Recovery After Surgery (ERAS) programs to be the standard of care. This revised systematic review and meta-analysis were conducted to better inform surgical practice by assessing the effect of an ERAS program on outcomes following benign and oncological gynecological surgery. To find studies that compared patients who had ERAS with those who did not, researchers looked through the electronic databases SCOPUS, Embase, and PubMed Medline.
Trials utilizing ERAS programs in gynecological surgery were included if they followed a well-defined protocol that incorporated at least 4 items from the most up-to-date standards and tracked a single primary outcome. Length of postoperative stay, readmission rates, and ileus rates were all subjected to a meta-analysis. To differentiate between benign and oncological procedures, additional subgroup analyses were conducted. The meta-analysis includes 15 randomized controlled trials and 25 cohort studies, totaling 40 studies and 7,885 people. The meta-analysis of the length of stay comprised 21 studies with a total of 4,333 individuals.
With ERAS, the length of stay for the study’s 2,351 participants was reduced by 1.22 days (95% CI: -1.59 to -0.86, P<0.00001) (1,982 patients). A meta-analysis of readmission rates involving 27 trials and 6,051 patients showed a 20% reduction in readmission rates (OR: 0.80, 95% CI: 0.65-0.97). When compared to the control group, the secondary outcome data showed a 47% decrease in the occurrence of ileus. In benign and oncological gynecological surgery, ERAS pathways dramatically reduce the length of stay without increasing readmission rates or ileus rates.