Enhanced Recovery Pathways in Gynecology and Gynecologic Oncology

Obstet Gynecol Surv. 2015 Dec;70(12):780-92. doi: 10.1097/OGX.0000000000000259.

Abstract

Importance: Enhanced recovery programs (ERPs) are considered standard of care across a variety of surgical disciplines, but ERPs have not been widely adopted in gynecology.

Objective: The aim of this study was to describe ERP principles and the role of ERPs in gynecology and gynecologic oncology.

Evidence acquisition: Comprehensive literature search was performed using MEDLINE, the Cochrane Collaboration Database, and PubMed.

Results: Meta-analyses of a substantial number of randomized controlled trials have shown that implementation of ERP protocols is associated with decreased length of hospital stay, a decrease in rates of postoperative complication, decreased morbidity, and cost savings while preserving patient satisfaction and quality of life.

Conclusions and relevance: High-quality evidence exists for improved outcomes among patients in ERPs. Enhanced recovery programs save resources and costs across the health care system. As quality metrics and bundled payments increase in health care, ERPs will have increasing prominence.

Publication types

  • Review

MeSH terms

  • Catheters
  • Diet
  • Drainage
  • Early Ambulation
  • Female
  • Genital Neoplasms, Female / surgery*
  • Gynecologic Surgical Procedures / adverse effects
  • Gynecologic Surgical Procedures / economics
  • Gynecologic Surgical Procedures / methods
  • Gynecologic Surgical Procedures / rehabilitation*
  • Humans
  • Pain Management
  • Preoperative Care
  • Water-Electrolyte Balance