title: Implementation of Enhanced Recovery After Surgery (ERAS) Pathways in Gynecologic Oncology. A NOGGO-AGO* survey of 144 Gynecological Departments in Germany.
abstract: OBJECTIVE
  To gather standardized information of current perioperative management of gynecological oncology patients and to evaluate up to what extent the Enhanced Recovery after Surgery (ERAS) elements are established in the clinical routine of gynecologic oncology units in Germany.
  
  
  METHODS
  We performed a multi-centric nationwide survey among 654 primary, secondary and maximal health care gynecological departments in Germany. A multiple-choice questionnaire based on the principles of ERAS was developed to gather information about perioperative management of two fictional cases in gynecological oncology.
  
  
  RESULTS
  One hundred four units (22%) have been taken the survey. Only 49.5% of surveyed hospitals claimed to be adherent to more than 70% of ERAS elements in managing perioperative period of primary cytoreductive surgery in ovarian cancer patients. 21% of these hospitals implemented more than 80% and only 8.4% implemented more than 90%. The results in border-line tumors operations did not differ from those of ovarian cancer operations.
  
  
  CONCLUSIONS
  The implementation of ERAS elements in gynecologic oncology in Germany is still not satisfying as only half of the departments will now be able to apply 70% of these principles. Therefore, we plan the second step of this survey in order to be able to build a consistent structured reporting platform between gynecological oncology units in Germany to facilitate the wide implementation and standardization of ERAS protocol.
authors.affiliation: Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany.
authors.forename: Mustafa Zelal
authors.initials: MZ
authors.lastname: Muallem
authors.affiliation: Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany Young Academy of Gynecologic Oncology (JAGO), Berlin, Germany.
authors.forename: Desislava
authors.initials: D
authors.lastname: Dimitrova
authors.affiliation: Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany Young Academy of Gynecologic Oncology (JAGO), Berlin, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Pietzner
authors.affiliation: Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Richter
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany.
authors.forename: Aarne
authors.initials: A
authors.lastname: Feldheiser
authors.affiliation: Department of Gynecology, Städtisches Krankenhaus Dresden-Neustadt, Dresden, Germany Young Academy of Gynecologic Oncology (JAGO), Berlin, Germany.
authors.forename: Irina
authors.initials: I
authors.lastname: Scharfe
authors.affiliation: Department of Gynecology, Dr. Horst-Schmidt- Klinik Wiesbaden, Wiesbaden, Germany Young Academy of Gynecologic Oncology (JAGO), Berlin, Germany.
authors.forename: Iryna
authors.initials: I
authors.lastname: Schmeil
authors.affiliation: Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany.
authors.forename: Teresa Maria
authors.initials: TM
authors.lastname: Hösl
authors.affiliation: Department of Obstetrics and Gynecology, Greifswald University Hospital, Greifswald, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Mustea
authors.affiliation: Department of Obstetrics and Gynecology, Dresden University of Technology, Dresden, Germany.
authors.forename: Pauline
authors.initials: P
authors.lastname: Wimberger
authors.affiliation: Department of Obstetrics and Gynecology, Campus Grosshadern, Munich University Hospital, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Burges
authors.affiliation: Department of Obstetrics and Gynecology, Essen University Hospital, Essen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Kimmig
authors.affiliation: Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany jalid.sehouli@charite.de.
authors.forename: Jalid
authors.initials: J
authors.lastname: Sehouli
mesh_terms: D000328:Adult; D002173:Cancer Care Facilities / Q000592:standards; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D005858:Germany; D006176:Gynecology / Q000592:standards; D019538:Health Care Surveys; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D019990:Perioperative Care / Q000592:standards; D058996:Quality Improvement
keywords: Enhanced recovery after surgery; fast track; gynecologic oncology