Comparison of outcomes following ERAS versus conventional care in gynecological surgeries: a retrospective study

Abstract

Background & objective: There have been very limited scale of Enhanced Recovery After Surgery (ERAS) protocol implementation to optimize recovery following surgery in Sri Lanka. We compared perioperative outcomes between ERAS-managed and conventionally managed patients undergoing major gynecological surgeries, stratified by laparoscopic and open approaches.

Methodology: A retrospective cohort study was conducted at Teaching Hospital Peradeniya, Sri Lanka, with 70
laparoscopic cases (35 ERAS, 35 non-ERAS) and 70 open cases (35 ERAS, 35 non-ERAS). Outcomes assessed included hospital length of stay (LOS), bowel recovery, flatus passage, postoperative complications, and 30-day readmissions. Descriptive statistics, Mann–Whitney U tests, and chi-square tests were employed, with significance set at P < 0.05.

Results: In laparoscopic cases, ERAS shortened time to flatus (23.4 vs 28.8 hours, P < 0.001), bowel opening (25.8 vs 33.6 hours, P < 0.001), and total hospital stay (3.17 vs 4.17 days, P = 0.005). Postoperative fever was lower with ERAS (2.9% vs 5.7%), with similar readmission rates (5.7%). In open cases, ERAS reduced total stay (4.26 vs 5.83 days, P = 0.004), postoperative stay (2.26 vs 3.69 days, P = 0.002), and bowel recovery time (32.9 vs 41.5 hours, P = 0.008). Readmissions were comparable. (14.3% ERAS vs 8.6% non-ERAS).

Conclusion: ERAS improves recovery, supporting its broader use in gynecological surgery in Sri Lanka to enhance efficiency and outcomes.

Keywords: Enhanced Recovery After Surgery; ERAS; Gynecological Surgical Procedures; Postoperative Period

Citation: Gnanarathne S, Rathnayaka T, Jayawardana M. Comparison of outcomes following ERAS versus
conventional care in gynecological surgeries: a retrospective study. Anaesth. pain intensive care 2026;30(2):200-
206. DOI: 10.35975/apic.v30i2.3127

Received: May 09, 2025; Revised: October 26, 2024; Accepted: January 01, 2025