Enhanced Recovery Pathways in Gynecology and Gynecologic Oncology

Importance Enhanced recovery programs (ERPs) are considered standard of care across a variety of surgical disciplines, but ERPs have not been widely adopted in gynecology. Objective The aim of this study was to describe ERP principles and the role of ERPs in gynecology and gynecologic oncology. Evidence Acquisition Comprehensive literature search was performed using MEDLINE, the Cochrane Collaboration Database, and PubMed. Results Meta-analyses of a substantial number of randomized controlled trials have shown that implementation of ERP protocols is associated with decreased length of hospital stay, a decrease in rates of postoperative complication, decreased morbidity, and cost savings while preserving patient satisfaction and quality of life. Conclusions and Relevance High-quality evidence exists for improved outcomes among patients in ERPs. Enhanced recovery programs save resources and costs across the health care system. As quality metrics and bundled payments increase in health care, ERPs will have increasing prominence. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner will be better able to specify the key components of enhanced recovery protocols, explain the rationale and benefit of enhanced recovery protocols across all surgical disciplines, and discuss the current body of evidence regarding enhanced recovery protocols in gynecology and gynecologic oncology patients.