The Enhanced Recovery After Surgery (ERAS) Society offers recommendations for pre- and intraoperative care in gynecologic/oncology surgery with the goal of standardizing perioperative care to help insure that all patients receive optimal treatment and is required to measure compliance. Among the evidence-based recommendations are:
• Although quality evidence is lacking, most studies show that counseling provides beneficial effects with no evidence of harm. It is recommended that patients should routinely receive dedicated preoperative counseling.
• Smoking is associated with increased postoperative morbidity and should be stopped at least 4 weeks before surgery. Alcohol is associated with increased perioperative morbidity and mortality and should be avoided for at least 4 weeks before surgery in patients who abuse alcohol.
• Anemia is associated with an increase in postoperative morbidity and mortality and should be identified, investigated, and corrected preoperatively. Iron therapy is the preferred first line treatment for the correction of iron deficiency anemia.
• Routine oral mechanical bowel preparation should not be used in gynecologic/oncology surgery, including patients with a planned enteric resection.
• Patients should be permitted to drink clear fluids until 2 hours before anesthesia and surgery. Patients should abstain from solids 6 hours prior to induction of anesthesia.
• Routine administration of sedatives to reduce anxiety preoperatively should be avoided in order to hasten postoperative recovery.
Citation: Nelson G, Altman AD, Nick A, et al. Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: enhanced recovery after surgery (ERAS) society recommendations – part I. [Published online ahead of print November 18, 2015]. Gynecologic Oncology doi: 10.1016/j.ygyno.2015.11.015.
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