Systematic Review of the Effect of Enhanced Recovery Following Surgery (ERAS) Usage in Gynecologic Surgery on Selected Attributes of Surgical Recovery

We aimed to systematically review the current available literature on enhanced recovery after surgery (ERAS) following gynecologic procedures either performed open or with minimally invasive gynecological surgery (MIGS) in terms of different outcomes. We have displayed the published literature and assessed the benefits and diverse outcomes of ERAS implementation in patients undergoing MIGS or other gynecologic surgery. We sought to examine the efficacy of entire ERAS protocols, faithfully performed, in order to determine if they were successful in improving individual attributes of surgical recovery. We systematically searched PubMed, Cochrane, Web of science, Scopus, MEDLINE and ClinicalTrials.gov in January 2021 for reliable studies. Data were extracted from eligible studies including the assessed outcomes as length of hospital stay, change in quality-of-life and recovery over time, postoperative complications including nausea and vomiting, opioid or anesthesia use, hospital cost, patient satisfaction, postoperative pain, readmission rate. Many included studies reported a significant reduction in the length of hospital stay postoperatively as well as readmission rates, hospital cost and postoperative nausea and vomiting. Also, there was a clinically significant increase in patient satisfaction in studies that used tools to measure patient satisfaction. No studies reported a significant increase in the overall Quality of Recovery (Qol) using appropriately validated tools. Following ERAS implementation, patients' postoperative rehabilitation, including postoperative discomfort, readmission rates, and satisfaction, showed a clinically significant improvement.