Efficacy And Safety Evaluation Of Modified Enhanced Recovery After Surgery In Gynecological Surgery

Objective:To evaluate the efficacy and safety of modified Enhanced Recovery after Surgery（ERAS）in elective or limited gynecological surgery.Methods:A total of 250 patients who underwent elective or limited surgery in the Department of Gynecology of our hospital from December 1,2020 to June 30,2021 were selected.They were randomly divided into modified ERAS group and traditional group,including 73 cases of laparoscopic modified ERAS group（group A1）and 62 cases of laparoscopic traditional group（group B1）,46 cases of hysteroscopic modified ERAS group（group A2）and 33 cases of hysteroscopic traditional group（group B2）,26 cases of laparotomy modified ERAS group（group A3）and 10 cases of laparotomy traditional group（group B3）.The postoperative length of stay（LOS）,the first time to get out of bed after the operation,the first time to eat after the operation,the time to the first anal exhaust after the operation,the postoperative body temperature,and the intravenous infusion volume on the day of operation,postoperative electrolytes and white blood cells,postoperative Visual Analogue Scale（VAS）score,postoperative nausea and vomiting（PONV）times,incidence of postoperative complications during hospitalization,hospitalization costs and complications after discharge to 3 months after operation were observed respectively in the two groups.Results:There was no significant difference in postoperative body temperature,postoperative electrolytes and white blood cells,and hospitalization costs between the two groups of lap aroscopic patients（P >0.05）.The laparoscopic indicators of VAS score,frequency of postop erative nausea and vomiting,time of first eating after operation,time of first anal flatus after operation,time of first getting out of bed after operation,incidence of postoperative complic ations during hospitalization and complications after discharge to 3 months after operation were significantly lower than those of the traditional laparoscopy group,and the difference was statistically significant（P <0.05）.The intravenous infusion volume on the day of operation in the hysteroscopic modified ERAS group was significantly smaller than that in the hysteros copic traditional group,and the difference was statistically significant（P <0.05）.There was no significant difference in other indicators（P >0.05）.The time of first getting out of bed after operation,the time of first eating after operation,and the time of first anal exhaust after operation in the laparotomy modified ERAS group were significantly shorter than those in the traditional group,and the differences were statistically significant（P <0.05）;there was no significant difference in other indicators（P >0.05）.Conclusion:The modified ERAS is effective and safe in elective or limited gynecological surgery,and it is especially worthy of application and promotion in gynecological laparoscopic surgery.