Effect of Fast-Track Surgery under ERAS protocol in Laparoscopic Hysterectomy: A Randomized Controlled Trial

Background & Objective: Fast-track surgery (FTS) consists of different pathways to decrease surgical complications and improve outcomes and patient satisfaction. FTS in an elective gynecologic laparoscopic surgery has not been well assessed. No consensus guidelines have been developed for gynecologic laparoscopic surgeries. The purpose of this study is to evaluate enhanced recovery after surgery (ERAS) for total laparoscopic hysterectomy.Materials & Methods: ۲۶۰ patients underwent for laparoscopic hysterectomy surgery. All patients were divided into two groups as follows: one group received traditional laparoscopic hysterectomy surgery and the intervention group was treated under ERAS protocol. ERAS protocol includes not receiving preoperative mechanical bowel preparation and laxatives as well as fasting ۶ h and not drinking liquids ۲h before surgery. The patients were allowed to resume the ordinary diet ۶h post-operation. Ondansetron ۴ mg were prescribed after surgery for nausea and vomiting, pain was controlled with non-narcotic analgesics diclofenac suppository ۱۰۰ mg/q۱۲ h and paracetamol ۱۰۰۰ mg/q۶ h until discharge. Urinary catheter was removed whenever possible and early ambulation occurred ۶h after the surgery.Results: A total of ۲۶۰ patients were studied. Regarding the length of hospitalization, significant differences were shown between the groups (P<۰.۰۰۱). Return to daily functions was occurred earlier in the fast-track surgery group than another group. Complications and VAS pain scores showed no significant differences between the groups.Conclusion: Our results show that ERAS surgery has fewer side effects and better outcomes which make it more suitable for patients undergoing laparoscopic hysterectomy.

Keywords:

Enhanced Postsurgical Recovery , laparoscopy , surgery , Hysterectomy