• Lena Wijk, Karin Franzen, Olle Ljungqvist, and Kerstin Nilsson.
• Department of Obstetrics and Gynecology, Örebro University, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
• Acta Obstet Gynecol Scand. 2014 Aug 1;93(8):749-56.

ObjectiveTo study the effects of introducing an Enhanced Recovery After Surgery (ERAS) protocol, modified for gynecological surgery, on length of stay and complications following abdominal hysterectomy.DesignObservational study.SettingDepartment of Obstetrics and Gynecology, Örebro University Hospital, Sweden.PopulationEighty-five patients undergoing abdominal hysterectomy for benign or malignant indications between January and December 2012, with or without salpingo-oophorectomy. Outcomes were compared with all consecutive patients who had undergone the same surgery from January to December 2011, immediately before establishing the ERAS protocol (n = 120).MethodsThe ERAS protocol was initiated in January 2012 as part of a targeted implementation program. Data were extracted from patient records and from a specific database.Main Outcome MeasuresLength of stay and the proportion of patients achieving target length of stay (2 days).ResultsLength of stay was significantly reduced in the study population after introducing the ERAS protocol from a mean of 2.6 (SD 1.1) days to a mean of 2.3 (SD 1.2) days (p = 0.011). The proportion of patients discharged at 2 days was significantly increased from 56% pre-ERAS to 73% after ERAS (p = 0.012). No differences were found in complications (5% vs. 3.5% in primary stay, 12% vs. 15% within 30 days after discharge), reoperations (2% vs. 1%) or readmission (4% vs. 4%).ConclusionsIntroducing the ERAS protocol for abdominal hysterectomy reduced length of stay without increasing complications or readmissions.© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

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