Enhanced recovery after surgery (ERAS): new concepts in perioperative management of gynecologic surgery

• Autor(a) principal: Agnaldo Lopes da Silva Filho
• Data de Publicação: 2018
• Outros Autores: Aline Evangelista Santiago, Sophie Françoise Mauricette Derchain, Jesus Paula Carvalho
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.1055/s-0038-1668581; http://hdl.handle.net/1843/52685; https://orcid.org/0000-0002-8486-7861
• topic: Gynecologic surgery; Postoperative; Care; Enhanced recovery after surgery; Conforto do paciente; Recuperação pós-cirúrgica melhorada; Cuidados pós-operatórios; Procedimentos cirúrgicos em ginecologia

The Enhanced Recovery After Surgery (ERAS) program is a paradigm shift from traditional perioperative management initiated by Kehlet in 19971 as a multidisciplinary approach to the care of the surgical patient. The programis based on perioperative medical optimization, including preoperative counseling, pain relief, carbohydrate loading, thromboembolism prophylaxis, standard anesthetic protocol and intraoperative fluid, recovery of normal gastrointestinal function, and early mobilization. The primary goal of the protocol is to minimize the response to the stress of the operation by maintaining homeostasis, avoiding catabolism with consequent loss of protein and muscle strength, and cellular dysfunction. Themain objectives of the ERAS programare to accelerate functional recovery, improve postoperative outcomes, shorten the length of stay (LOS) in the hospital, reduce the overall health care costs, and improve the satisfaction of the patients without increasing complications and/or hospital readmission rates. The ERAS protocols resulted in a 30% to 50% reduction in the LOS and similar reductions in complications, as well as lower costs and readmission rates. The protocols were developed for colorectal surgery, and variations are being adopted for surgical procedures of various specialties, including Gynecology.