Effect of enhanced recovery after surgery protocol for laparoscopic hysterectomy in benign indications: a retrospective cohort study.

OBJECTIVE

Enhanced Recovery After Surgery (ERAS) protocols have been proven to optimize recovery in various surgical disciplines, including gynecologic surgery. However, their impact on laparoscopic hysterectomy for benign conditions remains less explored. This study aims to evaluate the effect of the ERAS protocol on perioperative outcomes in patients undergoing laparoscopic hysterectomy for benign gynecologic conditions.

METHODS

A retrospective cohort study was conducted at our Hospital between January 2024 and June 2025. Patients undergoing laparoscopic hysterectomy were divided into the ERAS group (n = 54) and the conventional management group (n = 59) based on perioperative management during hospitalization. The primary outcomes measured were length of hospital stay, time to first ambulation, and time to first flatus. Secondary outcomes included complications, postoperative pain assessed using Visual Analog scale (VAS), gastrointestinal dysfunction assessed using the Simplified Postoperative Nausea and Vomiting Impact Scale (SPONVIS), and patient satisfaction assessed using Patient Satisfaction Questionnaire-18 (PSQ-18).

RESULTS

The ERAS group demonstrated a significant reduction in hospital stay (4.51 ± 1.21 days vs. 6.67 ± 1.08 days, p < 0.001), time to first ambulation (17.29 ± 3.69 h vs. 20.61 ± 4.11 h, p < 0.001), and time to first flatus (11.05 ± 2.89 h vs. 14.32 ± 2.31 h, p < 0.001) compared to the conventional management group. Additionally, the ERAS group showed lower VAS scores, SPONVIS scores, and overall complication rate (all p < 0.05).

CONCLUSION

The implementation of the ERAS protocol in laparoscopic hysterectomy for benign conditions may improve perioperative outcomes, including reducing hospital stay, accelerating recovery, and enhancing patient satisfaction without increasing complication rates.