A Study Of The Effect Of Accelerated Gynecological Rehabilitation Surgical Programs On The Occurrence Of Postoperative Complications In Patients

Objective:The establishment of gynecological ERAS department and its effect on compliance with gynecological ERAS protocol on postoperative complications were analyzed.The relationship between individual elements in rapid recovery protocols and postoperative complication rates was analyzed.Methods: From March 2022 to June 2022,360 patients who were admitted to thegynecology department in a tertiary hospital in Shenyang as the study subjects,173 were in non-ERAS departments and 187 were in ERAS departments.A prospective cohort study was used to investigate the application status of gynecological ERAS protocol,logistic regression analysis was used to establish gynecological ERAS departments and the influence of gynecological ERAS protocol adherence on patients’ postoperative outcomes,and multiple logistic regression was used to analyze the influence of individual items of gynecological ERAS program on postoperative complications in patients.Results:Pre-admission education and counseling,venous thrombosis prevention,oligoopioid analgesics,perioperative nutritional provision,and discharge pathway optimization were associated with high adherence in the ERAS department(adherence rate > 90%).The results showed that the number of complications was 114,the complication rate was 31.70%,and the complication rate in ERAS departments was lower than that in non-ERAS departments(27.80% VS 35.80%;OR:0.540;95%CI:0.348-0.839;P=0.006).The results showed that the complication rate was lower in the top 75% of patients than in the 25% after the adherence score(11.10% VS 54.40%;OR: 0.105;95% CI: 0.048-0.228;P=0.000)。 Preoperative education and counseling,preoperative optimization,perioperative targeted fluid-directed therapy,and early postoperative activities were independent influencing factors for the occurrence of postoperative complications in patients undergoing gynecological surgery(P<0.05).Conclusion:(1)Medical institutions had good compliance with some gynecological ERAS program items,including prevention of venous thrombosis,perioperative nutritional support,pre-admission education and consultation,strategies to reduce surgical site infection,oligo-opioid multimodal analgesia,and discharge path optimization.(2)Whether or not it belongs to the ERAS department and the adherence to the gynecological ERAS protocol will affect the postoperative outcome of patients undergoing gynecological surgery.However,adherence to the gynaecological ERAS protocol had a greater impact on postoperative outcomes than whether or not it belonged to an ERAS department.(3)Pre-admission education and counseling,preoperative optimization,perioperative fluid management,and early activities were independently correlated with the incidence of postoperative complications in patients undergoing gynecological surgery.