European Enhanced Recovery After Surgery (<scp>ERAS</scp>) gynecologic oncology survey: Status of <scp>ERAS</scp> protocol implementation across Europe
Natalia R. Gómez‐Hidalgo, Andrei Pletnev, Zoia Razumova, Nicolò Bizzarri, İlker Selçuk, Charalampos Theofanakis, Kamil Zalewski, Tanja Nikolova, Maximilian Lanner, Joanna Kacperczyk‐Bartnik, Houssein El Hajj, Assumpció Pérez‐Benavente, Gregg Nelson, Antonio Gil‐Moreno, Christina Fotopoulou, José Luís Sánchez-Iglesias
Abstract
OBJECTIVE: To acquire a comprehensive assessment of the current status of implementation of Enhanced Recovery After Surgery (ERAS) protocols across Europe. METHODS: The survey was launched by The European Network of Young Gynecologic Oncologists (ENYGO). A 45-item survey was disseminated online through the European Society of Gynecological Oncology (ESGO) Network database. RESULTS: A total of 116 ESGO centers participated in the survey between December 2020 and June 2021. Overall, 80 (70%) centers reported that ERAS was implemented at their institution: 63% reported a length of stay (LOS) for advanced ovarian cancer surgery between 5 and 7 days; 57 (81%) centers reported a LOS between 2 and 4 days in patients who underwent an early-stage gynecologic cancer surgery. The ERAS items with high reported compliance (>75% "normally-always") included deep vein thrombosis prophylaxis (89%), antibiotic prophylaxis (79%), prevention of hypothermia (55%), and early mobilization (55%). The ERAS items that were poorly adhered to (less than 50%) included early removal of urinary catheter (33%), and avoidance of drains (25%). CONCLUSION: This survey shows broad implementation of ERAS protocols across Europe; however, a wide variation in adherence to the various ERAS protocol items was reported.