Integration of an enhanced recovery after surgery program for patients undergoing pituitary surgery

World J Otorhinolaryngol Head Neck Surg. 2022 May 2;8(4):330-338. doi: 10.1016/j.wjorl.2021.04.004. eCollection 2022 Dec.

Abstract

Evidence-based enhanced recovery after surgery (ERAS) programs aim to improve patient outcomes and shorten hospital stays. The objective of this study is to describe the development, implementation, and evolution of an ERAS protocol to optimize the perioperative management for patients undergoing endoscopic skull base surgery for pituitary tumors. A systematic review of the literature was performed, best practices were discussed with stakeholders, and institutional guidelines were established and implemented. Key performance indicators (KPI) were measured and patient-reported outcome surveys were collected. The ERAS protocol was introduced successfully at our institution. We describe the process of initiation of the program and the perioperative management of our patients. We demonstrated the feasibility of integration of ERAS protocols for pituitary tumors with multidisciplinary engagement, with a particular emphasis on the use of data informatics and metrics to monitor outcomes. We expect that this approach will translate to improved quality of care for these often-complex patients.

Keywords: Endoscopic skull base surgery; Enhanced recovery after surgery; Outcomes improvement; Pituitary surgery.