Enhanced recovery for gynaecological surgery: a review

Authors

  • Christopher F YIM
  • Mona WC LAM

DOI:

https://doi.org/10.12809/hkjgom.19.2.07

Keywords:

Convalescence, Gynecologic surgical procedures

Abstract

We review various aspects of enhanced recovery after surgery for gynaecological patients, including patient education and counselling, preoperative assessment and optimisation, preoperative fasting and nutrition, bowel preparation, thromboembolism prophylaxis, perioperative analgesia, peritoneal drains and urinary catheters, postoperative nausea and vomiting, hypothermia prevention, early feeding and early mobilisation, and implementation of enhanced recovery after surgery.

References

Bardram L, Funch-Jensen P, Jensen P, Crawford ME, Kehlet H. Recovery after laparoscopic colonic surgery with epidural analgesia, and early oral nutrition and mobilisation. Lancet 1995;345:763-4.

Adamina M, Kehlet H, Tomlinson GA, Senagore AJ, Delaney CP. Enhanced recovery pathways optimize health outcomes and resource utilization: a meta-analysis of randomized controlled trials in colorectal surgery. Surgery 2011;149:830-40.

Ljungqvist O, Hubner M. Enhanced recovery after surgery-ERAS-principles, practice and feasibility in the elderly. Aging Clin Exp Res 2018;30:249-52.

Varadhan KK, Neal KR, Dejong CH, Fearon KC, Ljungqvist O, Lobo DN. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr 2010;29:434-40.

Kroon UB, Rådström M, Hjelthe C, Dahlin C, Kroon L. Fasttrack hysterectomy: a randomised, controlled study. Eur J Obstet Gynecol Reprod Biol 2010;151:203-7.

de Groot JJ, Ament SM, Maessen JM, Dejong CH, Kleijnen JM, Slangen BF. Enhanced recovery pathways in abdominal gynecologic surgery: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 2016;95:382-95.

Dahanukar SA, Thatte UM, Deshmukh UD, Kulkarni MK, Bapat RD. The influence of surgical stress on the psychoneuro-endocrine-immune axis. J Postgrad Med 1996;42:12-4.

Carli F. Physiologic considerations of enhanced recovery after surgery (ERAS) programs: implications of the stress response. Can J Anaesth 2015;62:110-9.

Crippa J, Mari GM, Miranda A, Costanzi AT, Maggioni D. Surgical stress response and enhanced recovery after laparoscopic surgery: a systematic review. Chirurgia (Bucur) 2018;113:455-63.

Grant MC, Galante DJ, Hobson DB, et al. Optimizing an enhanced recovery pathway program: development of a postimplementation audit strategy. Jt Comm J Qual Patient Saf 2017;43:524-33.

Forsmo HM, Pfeffer F, Rasdal A, et al. Compliance with enhanced recovery after surgery criteria and preoperative and postoperative counselling reduces length of hospital stay in colorectal surgery: results of a randomized controlled trial. Colorectal Dis 2016;18:603-11.

Gillis C, Gill M, Marlett N, et al. Patients as partners in enhanced recovery after surgery: a qualitative patient-led study. BMJ Open 2017;7:e017002.

Fowler AJ, Ahmad T, Abbott TEF, et al. Association of preoperative anaemia with postoperative morbidity and mortality: an observational cohort study in low-, middle-, and high-income countries. Br J Anaesth 2018;121:1227-35.

Dietrich W, Faraoni D, von Heymann C, et al. ESA guidelines on the management of severe perioperative bleeding: comments on behalf of the Subcommittee on Transfusion and Haemostasis of the European Association of Cardiothoracic Anaesthesiologists. Eur J Anaesthesiol 2014;31:239-41.

Kotze A, Harris A, Baker C, et al. British Committee for Standards in Haematology Guidelines on the Identification and Management of Pre-Operative Anaemia. Br J Haematol 2015;171:322-31.

Lau CW. Iron therapy in obstetrics and gynaecology: a review. Hong Kong J Gynaecol Obstet Midwifery 2019;19:49-55.

Quan J, Li TK, Pang H, et al. Diabetes incidence and prevalence in Hong Kong, China during 2006-2014. Diabet Med 2017;34:902-8.

Membership of the Working Party, Barker P, Creasey PE, et al. Peri-operative management of the surgical patient with diabetes 2015: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia 2015;70:1427-40.

Phillips S, Hutchinson S, Davidson T. Preoperative drinking does not affect gastric contents. Br J Anaesth 1993;70:6-9.

Smith I, Kranke P, Murat I, et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 2011;28:556-69.

Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev 2014;8:CD009161.

Guenaga KK, Matos D, Wille-Jørgensen P. Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev 2009;1:CD001544.

Arnold A, Aitchison LP, Abbott J. Preoperative mechanical bowel preparation for abdominal, laparoscopic, and vaginal surgery: a systematic review. J Minim Invasive Gynecol 2015;22:737-52.

NICE guideline [NG23]. Menopause: diagnosis and management. Available from: https://www.nice.org.uk/guidance/NG23. Accessed 22 May 2019.

NICE guideline [NG89]. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. Available from: https://www.nice.org.uk/guidance/NG89. Accessed 22 May 2019.

Nelson G, Altman AD, Nick A, et al. Guidelines for postoperative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations--Part I. Gynecol Oncol 2016;140:313-22.

Barletta JF. Clinical and economic burden of opioid use for postsurgical pain: focus on ventilatory impairment and ileus. Pharmacotherapy 2012;32(9 Suppl):12S-8S.

Kessler ER, Shah M, Gruschkus SK, Raju A. Cost and quality implications of opioid-based postsurgical pain control using administrative claims data from a large health system: opioid-related adverse events and their impact on clinical and economic outcomes. Pharmacotherapy 2013;33:383-91.

McNicol ED, Ferguson MC, Haroutounian S, Carr DB, Schumann R. Single dose intravenous paracetamol or intravenous propacetamol for postoperative pain. Cochrane Database Syst Rev 2016;5:CD007126.

Ong CK, Lirk P, Tan CH, Seymour RA. An evidence-based update on nonsteroidal anti-inflammatory drugs. Clin Med Res 2007;5:19-34.

Ong CK, Seymour RA, Lirk P, Merry AF. Combining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain. Anesth Analg 2010;110:1170-9.

Alayed N, Alghanaim N, Tan X, Tulandi T. Preemptive use of gabapentin in abdominal hysterectomy: a systematic review and meta-analysis. Obstet Gynecol 2014;123:1221-9.

Yao Z, Shen C, Zhong Y. Perioperative pregabalin for acute pain after gynecological surgery: a meta-analysis. Clin Ther 2015;37:1128-35.

Ferguson SE, Malhotra T, Seshan VE, et al. A prospective randomized trial comparing patient-controlled epidural analgesia to patient-controlled intravenous analgesia on postoperative pain control and recovery after major open gynecologic cancer surgery. Gynecol Oncol 2009;114:111-6.

Belavy D, Janda M, Baker J, Obermair A. Epidural analgesia is associated with an increased incidence of postoperative complications in patients requiring an abdominal hysterectomy for early stage endometrial cancer. Gynecol Oncol 2013;131:423-9.

Salicath JH, Yeoh EC, Bennett MH. Epidural analgesia versus patient-controlled intravenous analgesia for pain following intra-abdominal surgery in adults. Cochrane Database Syst Rev 2018;8:CD010434.

Bacal V, Rana U, McIsaac DI, Chen I. Transversus abdominis plane block for post hysterectomy pain: a systematic review and meta-analysis. J Minim Invasive Gynecol 2019;26:40-52.

Fassoulaki A, Chassiakos D, Melemeni A. Intermittent epidural vs continuous wound infusion of ropivacaine for acute and chronic pain control after hysterectomy or myomectomy: a randomized controlled trial. Pain Med 2014;15:1603-8.

Charoenkwan K, Kietpeerakool C. Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in patients with gynaecological malignancies. Cochrane Database Syst Rev 2014;6:CD007387.

Nelson G, Altman AD, Nick A, et al. Guidelines for postoperative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations--Part II. Gynecol Oncol 2016;140:323-32.

Kalogera E, Dowdy SC. Enhanced recovery pathway in gynecologic surgery: improving outcomes through evidence-based medicine. Obstet Gynecol Clin North Am 2016;43:551-73.

Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2014;118:85-113.

Apfel CC, Läärä E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology 1999;91:693-700.

Chan S, Lam TH, Wong D, et al. Smoking and health survey in Hong Kong Women. COSH Report No.15. Available from: https://www.smokefree.hk/UserFiles/resources/about_us/cosh_reports/COSHRN_E15.pdf. Accessed 14 May 2019.

Apfel CC, Korttila K, Abdalla M, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med 2004;350:2441-51.

Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med 1996;334:1209-15.

Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology 2008;108:71-7.

Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet 1996;347:289-92.

Frank SM, Beattie C, Christopherson R, et al. Unintentional hypothermia is associated with postoperative myocardial ischemia. The Perioperative Ischemia Randomized Anesthesia Trial Study Group. Anesthesiology 1993;78:468-76.

Putzu M, Casati A, Berti M, Pagliarini G, Fanelli G. Clinical complications, monitoring and management of perioperative mild hypothermia: anesthesiological features. Acta Biomed 2007;78:163-9.

Charoenkwan K, Phillipson G, Vutyavanich T. Early versus delayed (traditional) oral fluids and food for reducing complications after major abdominal gynaecologic surgery. Cochrane Database Syst Rev 2007;4:CD004508.

Obermair A, Simunovic M, Isenring L, Janda M. Nutrition interventions in patients with gynecological cancers requiring surgery. Gynecol Oncol 2017;145:192-9.

van der Leeden M, Huijsmans R, Geleijn E, et al. Early enforced mobilisation following surgery for gastrointestinal cancer: feasibility and outcomes. Physiotherapy 2016;102:103-10.

Scheib SA, Thomassee M, Kenner JL. Enhanced recovery after surgery in gynecology: a review of the literature. J Minim Invasive Gynecol 2019;26:327-43.

Barber EL, Van Le L. Enhanced recovery pathways in gynecology and gynecologic oncology. Obstet Gynecol Surv 2015;70:780-92.

Miralpeix E, Nick AM, Meyer LA, et al. A call for new standard of care in perioperative gynecologic oncology practice: impact of enhanced recovery after surgery (ERAS) programs. Gynecol Oncol 2016;141:371-8.

Royal College of Obstetricians and Gynaecologists. Enhanced Recovery in Gynaecology (Scientific Impact Paper No. 36). Available from: https://www.rcog.org.uk/en/guidelinesresearch-services/guidelines/sip36/. Accessed 22 May 2019.

National Health Service. Enhanced Recovery Partnership Programme. Report - March 2011. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215511/dh_128707.pdf. Accessed 14 May 2019.

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Published

2023-04-06

How to Cite

1.
YIM CF, LAM MW. Enhanced recovery for gynaecological surgery: a review. Hong Kong J Gynaecol Obstet Midwifery [Internet]. 2023 Apr. 6 [cited 2024 Apr. 26];19(2). Available from: https://hkjgom.org/home/article/view/267

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Perspective