Application Of Accelerated Recovery After Surgery In Elective Gynecological Surger

Objective:The concept of enhanced recovery after gynecologic procedures is attracting greater attention worldwide as it shortens the length of(hospital)stay(LOS),improves patient outcomes,and heightens satisfaction.The aim of the current study was to generate a recovery curve for women undergoing gynecologic surgery by applying an enhanced recovery after surgery(ERAS)pathway,and we investigated the relevant factors that affected the recovery of the patients.Methods:The clinical data of 192 patients who underwent elective minimally invasive gynecologic surgery or open gynecologic surgery for benign gynecological diseases in the fourth ward of the Department of Gynecology of Peking Union Medical College Hospital from June 2022 to September 2022 were analyzed retrospectively.A11 patients subsequently underwent an enhanced recovery program,and we evaluated the results by deploying the EuroQol Five Dimensions Questionnaire(EQ-5D).A correlation analysis of age,body mass index(BMI),preoperative hemoglobin value,operative time,specific projects of ERAS,ERAS completion rate,and EQ-VAS was then executed.SPSS25.0 statistical software was used for multivariate analysis.Results:1.A total of 192 patients undergoing elective surgery were included in this study,all patients were successfully performed,all patients were followed up.Finally,192 patients were included in statistical analysis,including 154 cases of laparoscopic surgery and 38 cases of open surgery.2.The number of days required for the patient to recover postoperatively ranged from 3 to 60 d.3.Patients had a preoperative EQ-5D VAS score of 81.27±14.44,a score of 63.72±16.83 on the day of surgery,a score of 70.70±13.23 on postoperative day 1,and a score of 76.62±10.54 on postoperative day 2.The mean number of days needed to attain a healthy state after surgery was 19.23±12.59 d,and the VAS score at the time of achieving a healthy state was 90.58±7.91.A patient’s perioperative recovery curve was thus derived from the EQ-5D VAS score.4.Multivariate analysis showed that the preoperative EQ-VAS of patients,operative time,ERAS completion rate,and termination of intravenous fluid replacement within 24 h were the principal influencing factors for the VAS score on postoperative day 2(P<0.05).5.Multivariate analysis showed that the preoperative HGB level and the prevention of POVN were the principal influencing factors for postoperative recovery time(P<0.05).Conclusion:1.Accelerating postoperative rehabilitation measures can accelerate the perioperative recovery of patients undergoing gynecological surgery and improve the quality of life after operation.2.For patients undergoing elective surgery,perioperative monitoring should be strengthened and individualized treatment strategies should be formulated so as to improve the outcome of patients.Objective:Based on the application of ERAS perioperative intervention,the feasibility and safety of electrophysiological technology in promoting the recovery of intestinal function after laparotomy in gynecological patients were discussed,and a more mature and standardized application method was established.Methods:A prospective count of 30 patients who underwent elective laparotomy for gynecological diseases in the fourth ward of the Department of Gynecology of Peking Union Medical College Hospital from October 2021 to June 2022 were randomly enrolled in the experimental group and 50%in the control group.The experimental group received ERAS perioperative treatment and postoperative electrophysiological stimulation,that is,the low-frequency neuromuscular therapy device BioStim pro was used,and the control group only received ERAS perioperative treatment,without postoperative electrophysiological stimulation.The first exhaust time,first bowel movement time,postoperative complications and other indicators of the two groups were collected,and whether there was a significant difference in the above perioperative outcomes between the two groups was compared.SPSS25.0 statistical software was used for analysis.Results:1.A total of 30 patients undergoing elective surgery were included in this study,all patients successfully underwent surgery,all patients completed follow-up,and finally 30 patients were included in statistical analysis.2.The first exhaust time of the experimental group was(676.93±294.38)min,and the first exhaust time of the control group was(1258.33±638.08)min,and the difference was statistically significant.3.The first bowel movement time of the experimental group was(1664.27±710.19)min,and the first defecation time of the control group was(2573.33±1169.03)min,and the difference was statistically significant.4.There was no significant difference in postoperative complications between the two groups.Conclusion:Percutaneous electrical nerve stimulation in combination with ERAS is safe and effective in gynecological laparotomy.