Implementation of enhanced recovery after surgery for endometrial carcinoma: A non-randomized controlled trial

Study aim: to look at the effect of modified better enhanced recovery after surgery (ERAS) program for endometrial carcinoma, on hospital live length (HLL) and operative outcome. Patients & methods: the study was done in El-Salam Oncology center; Cairo and Minia Maternity University Hospital, Miniauniversity,Egypt. The study included two groups of patients diagnosed as endometrial carcinoma prepared for operations. First group included patients prepared for laparoscopy (n=27) and was managed with ERAS protocol. The other group of patients were prepared for laparotomy (n=31) and was managed with conventional protocol. Results: The HLL was abridged in ERAS group when linked with the control group (1.77 ± 1.13 days compared with 6.13 ± 2.25 days; P < 0.0001; CI 3.4013 to 5.3187). Opioid use was reduced in ERAS group compared to the control groups (1.10 ± 0.41mg and 9.83 ± 3.6 mg; P < 0.0001) and postoperative fluid use was also less in the ERAS group compared to the control group (1362.9 ± 234.3 ml compared with 2303.2 ± 512 ml; P < 0.0001; CI 725.4990 to 1155.1010). Conclusion: Implementation of ERAS protocols in gynecologic surgery for endometrial carcinoma should be tailored according to the situation of each case. But in general, ERAS was connected with substantial reduction in HLL, lessening in the operative time and blood loss, associated with controlled intravenous fluids utilized and comparable pain control to conventional protocols with improvement in complication rates.