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372 Implementation of the eras protocol (enhanced recovery alter surgery) at a gynecologic oncology unit in a low resource setting

Objectives To evaluate the postoperative outcome of patients managed according to the ERAS guidelines. Methods Retrospective study, 92 patients were included, they underwent radical surgery at our Unit. Period: June 2016 to December 2018. Since we work in a low resource setting, only some of the ERAS criteria could be applied (pre-surgical counseling, general preparation, peri and operative measures). Results 92 patientes included: 46 had an ovarian cancer, 33 a cervical cancer and 13 an endometrial cancer. The median age was 49.6 years. A Radical Laparoscopic Surgery was performed in 15 of the cases and the other 77 patients were submitted to a Laparotomic (Abdominal) Surgery. Median surgical time was 199 minutes (60- 370). The average hospital stay was 3.33 days (1–13). Combined anesthesia was performed in 34 of the laparotomic surgeries. NGT was left in 6 patients. NGT and BC were withdrawn in 89 cases within 24 hours. Only 10 out of the 92 patients required rescue medication for postoperative pain management. Only 3 patients required bowel resection without any complications. Five patients required blood transfusions. In 23 patients intraabdominal drainage was placed and in 20 of them it was removed within 24 hours. Nobody presented emesis in the postoperative period. One patient developed bilateral DVT. The average value of postoperative glycemia was 150 (91 - 289). There were no readmissions. Conclusions It was very difficult to implement the ERAS guidelines.Our patients had a good postoperative outcome. This allowed early institutional discharge. The ERAS protocol did not increase the costs of hospitalization.