Prehabilitation in an ERAS program for endometrial cancer patients: impact on post-operative recovery.

Autor:	Miralpeix E; Department of Obstetrics and Gynecology, Hospital del Mar, Barcelona, Catalunya, Spain ester.miralpeix@gmail.com., Fabregó B; Department of Obstetrics and Gynecology, Hospital del Mar, Barcelona, Catalunya, Spain., Rodriguez-Cosmen C; Department of Anesthesia, Hospital del Mar, Barcelona, Catalunya, Spain., Solé-Sedeño JM; Department of Obstetrics and Gynecology, Hospital del Mar, Barcelona, Catalunya, Spain., Gayete S; Department of Obstetrics and Gynecology, Hospital del Mar, Barcelona, Catalunya, Spain., Jara-Bogunya D; Family and Community Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Catalunya, Spain., Corcoy M; Department of Anesthesia, Hospital del Mar, Barcelona, Catalunya, Spain., Mancebo G; Department of Obstetrics and Gynecology, Hospital del Mar, Barcelona, Catalunya, Spain.
Jazyk:	angličtina
Zdroj:	International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2023 Apr 03; Vol. 33 (4), pp. 528-533. Date of Electronic Publication: 2023 Apr 03.
DOI:	10.1136/ijgc-2022-004130
Abstrakt:	Objectives: Enhanced recovery after surgery (ERAS) and prehabilitation programs are multidisciplinary care pathways that aim to reduce stress response and improve perioperative outcomes. However, literature is limited regarding the impact of ERAS and prehabilitation in gynecologic oncology surgery. The aim of this study was to assess the impact of implementing an ERAS and prehabilitation program on post-operative outcomes of endometrial cancer patients undergoing laparoscopic surgery. Methods: We evaluated consecutive patients undergoing laparoscopy for endometrial cancer that followed ERAS and the prehabilitation program at a single center. A pre-intervention cohort that followed the ERAS program alone was identified. The primary outcome was length of stay, and secondary outcomes were normal oral diet restart, post-operative complications and readmissions. Results: A total of 128 patients were included: 60 patients in the ERAS group and 68 patients in the prehabilitation group. The prehabilitation group had a shorter length of hospital stay of 1 day (p<0.001) and earlier normal oral diet restart of 3.6 hours (p=0.005) in comparison with the ERAS group. The rate of post-operative complications (5% in the ERAS group and 7.4% in the prehabilitation group, p=0.58) and readmissions (1.7% in the ERAS group and 2.9% in the prehabilitation group, p=0.63) were similar between groups. Conclusions: The integration of ERAS and a prehabilitation program in endometrial cancer patients undergoing laparoscopy significantly reduced hospital stay and time to first oral diet as compared with ERAS alone, without increasing overall complications or the readmissions rate. Competing Interests: Competing interests: None declared. (© IGCS and ESGO 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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