title: Enhanced Recovery after Surgery Protocol in Abdominal Hysterectomies for Malignant versus Benign Disease.
abstract: BACKGROUND
  The enhanced recovery after surgery (ERAS) protocol combines unimodal evidence-based interventions aiming to enhance recovery after surgery and reduce length of stay (LOS). We introduced an ERAS protocol in gynecological surgery and compared outcomes after hysterectomies performed for malignant vs. benign indications.
  
  
  METHODS
  This prospective cohort study was conducted at the Department of Obstetrics and Gynecology, Örebro University Hospital, Sweden, among 121 consecutive patients undergoing abdominal hysterectomy and salpingo-oophorectomy for malignant (n = 40) or benign (n = 81) indications between 2012 and 2014. Clinical data were prospectively collected and extracted from the patient records and from a specific database. The primary outcomes were LOS and proportion of patients achieving target LOS (2 days).
  
  
  RESULTS
  Patients operated for malignant vs. benign disease did not differ significantly in terms of LOS (2 (1-5) vs. 2 (1-11) days; p = 0.505), proportion discharged at target LOS (62 vs. 69%; p = 0.465; OR 0.74, 95% CI 0.3-1.6), complications (2 vs. 7% in primary stay, 8 vs. 11% within 30 days after discharge), reoperations (0 vs. 2%), or readmissions (2 vs. 1%).
  
  
  CONCLUSIONS
  The ERAS protocol may be equally applicable to patients undergoing hysterectomy either for a malignant or for a benign disease.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences and Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Wijk
authors.forename: Karin
authors.initials: K
authors.lastname: Franzén
authors.forename: Olle
authors.initials: O
authors.lastname: Ljungqvist
authors.forename: Kerstin
authors.initials: K
authors.lastname: Nilsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols / Q000592:standards*; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D010052:Ovariectomy / Q000379:methods; D019990:Perioperative Care / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D058994:Salpingectomy / Q000379:methods