Enhanced recovery after gynecological surgery: A meta-analysis of randomized controlled trials

Nurs Health Sci. 2023 Mar;25(1):30-43. doi: 10.1111/nhs.13000. Epub 2023 Jan 3.

Abstract

Enhanced recovery after surgery protocol is a multidisciplinary and multimodal approach designed to improve perioperative outcomes for patients. This meta-analysis aimed to identify and elaborate on the efficacy of this protocol in women undergoing gynecologic surgery. Four databases were searched for randomized controlled trials from inception to December 2021. A total of 14 studies met the inclusion criteria and were analyzed. There was a significant reduction in the length of stay, the time to first flatus and first defecation, complications, and readmission rates in patients undergoing enhanced recovery after surgery when compared to routine care. The rate of discharge on the first postoperative day significantly increased in patients from the enhanced recovery group. There was no significant difference in the surgery time and blood loss. In conclusion, the enhanced recovery after surgery protocol might have a positive effect on patients undergoing gynecologic surgery. However, there is still heterogeneity between the included studies, and we need more research to draw reliable conclusions that enhanced recovery after surgery is favorable.

Keywords: enhanced recovery after surgery; gynecological surgery; length of stay; meta-analysis; randomized controlled trials; systematic review.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Female
  • Gynecologic Surgical Procedures* / adverse effects
  • Gynecologic Surgical Procedures* / methods
  • Humans
  • Length of Stay
  • Patient Discharge*
  • Postoperative Complications / etiology
  • Randomized Controlled Trials as Topic