Navigation Links
Mayo Clinic: Enhanced recovery pathway for gynecologic surgery gets patients back to health faster
Date:8/26/2013

ROCHESTER, Minn. -- Patients who had complex gynecologic surgery managed by an enhanced recovery pathway (ERP) resulted in decreased narcotic use, earlier discharge, stable readmission rates, excellent patient satisfaction and cost savings, according to a Mayo Clinic study. The findings are published in the journal Obstetrics & Gynecology.

MULTIMEDIA ALERT: Video and audio of Dr. Dowdy are available for download on the Mayo Clinic News Network.

A team of gynecologic oncologists, urogynecologists and anesthesiologists developed an enhanced recovery pathway for patients undergoing gynecologic surgery to recover more quickly. Prior to the ERP for gynecologic surgery, patients had extensive bowel preparations, caloric restriction, received more intravenous fluids, bed rest, high rates of intravenous opioid use, and drains and catheters were used liberally. The ERP standardized postoperative management to avoid prolonged preoperative fasting and eliminated bowel cleansing. Patients are eating, drinking and ambulating shortly after surgery. In addition, drains and nasogastric tubes are not routinely used and urinary catheters are promptly removed after 24 hours. Patients receive limited IV narcotics and their fluid is restricted to avoid fluid overload.

"Patients are much happier when we are able to eliminate the use of unproven and unpleasant interventions such as bowel preparations, caloric restriction, sedating medications and the use of surgical drains," says Sean Dowdy, M.D., a Mayo Clinic gynecologic surgeon and lead study author. "We show that patients undergoing the most complex and invasive operations have the most to gain from this recovery pathway."

In a retrospective study, the researchers studied the outcomes of 241 women who followed the ERP during a six-month period and compared them to 235 women who did not follow the ERP during a nine-month period. The patients were divided into three cohorts: patients with complicated vaginal surgeries due to pelvic floor dysfunction; surgery through the abdomen for hysterectomy and lymph node dissection for ovarian or endometrial cancer; and extensive, complex surgeries for patients with ovarian cancer.

Though all three groups had dramatic improvements, the researchers found that patients who underwent surgery for ovarian cancer had the most significant improvement in recovery. These patients need extensive surgery that can last 4 to 8 hours and their average hospital stay is about 10 days. For this group, intravenous narcotic use decreased from 98.7 percent to 33.3 percent; overall narcotic use decreased by 80 percent within the first 48 hours after surgery; patients had a four-day reduction in hospital stay and cost of care was reduced 18.8 percent due to the shorter hospital stay.

"Our goal after surgery is for patients to recover as quickly as possible in order for them to return home to their families and get back to normal activities as soon as possible," Dr. Dowdy says.

The use of the ERP allows patients to have a more rapid recovery with faster return of bowel function, stable pain scores despite reduced narcotic use, excellent patient satisfaction and stable complication and readmission rates.

"There is accumulating evidence that patients who receive chemotherapy sooner rather than later for example, patients with ovarian cancer, have improved outcomes," Dr. Dowdy says. "Thus, the quicker recovery made possible by this pathway may allow patients to receive other recommended therapies, such as chemotherapy, sooner." The researchers conclude that the enhanced recovery pathway substantially improves the outcome and the quality of care for patients undergoing complex and extensive gynecologic surgeries.


'/>"/>

Contact: Kelley Luckstein
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
Source:Eurekalert

Related medicine news :

1. Mayo Clinic: Preclinical tests may lead to new approach to treat CNS lymphoma
2. Mayo Clinic: Rotavirus vaccine given to newborns in Africa is effective
3. Mayo Clinic: How gold nanoparticles can help fight ovarian cancer
4. Mayo Clinic: Inflammatory bowel disease raises risk of melanoma
5. Mayo Clinic: Scheduled imaging studies provide little help detecting relapse of aggressive lymphoma
6. Mayo Clinic: New multiple myeloma treatment guidelines personalize therapy for patients
7. Mayo Clinic: Skin problems, joint disorders top list of reasons people visit doctors
8. Mayo Clinic: 2-drug combination may slow deadly thyroid cancer
9. Mayo Clinic: Less invasive surgery detects residual breast cancer in lymph nodes after chemotherapy
10. Mayo Clinic: Antidepressant eases radiation-related mouth pain in head, neck cancer
11. Mayo Clinic: Diabetes can be controlled in patients after pancreas removal
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/23/2017)... NJ (PRWEB) , ... February 23, 2017 , ... ... in thought leadership , media relations, content marketing, social media management, corporate ... several clients already in the state and in nearby New Hampshire, Massachusetts and ...
(Date:2/23/2017)... ... February 23, 2017 , ... On April 13, ... symposium on “Doping in Sport: How the Culture Might Change,” in ... LLP. The symposium will be held at Pepperdine University in Malibu, California. , ...
(Date:2/23/2017)... ... February 23, 2017 , ... ... interactive publication where generations converge and explore the world from different perspectives. By ... Magazine enables readers to gain understanding, increase empathy, and find greater happiness. ...
(Date:2/23/2017)... ... February 23, 2017 , ... ... today that it will soon begin franchising throughout the U.S. starting this spring. ... help bring the practice of meditation mainstream. Current Meditation will be the first ...
(Date:2/23/2017)... ... February 23, 2017 , ... ... partnership with the Rhode Island Consortium for Autism Research and Treatment (RI-CART) and ... children with autism spectrum disorder (ASD) to see films in an environment that ...
Breaking Medicine News(10 mins):
(Date:2/24/2017)... Research and Markets has announced the addition of the "Dry eye ... ... eye Drugs Price Analysis and Strategies - 2016, provides drug pricing data ... the following questions: What are the key ... positioned in the Global Dry eye market? What are ...
(Date:2/24/2017)... , Feb. 24, 2017 Medical ... ways to increase their self-service capabilities to manage ... Providers (HCPs). New research from consulting ... organizations have developed self-service website portals where HCPs ... is just one of many findings to emerge ...
(Date:2/24/2017)... , Feb. 23, 2017 Report analyzes the ... provides separate comprehensive analytics for the US, Canada ... , Asia-Pacific , Latin ... forecasts are provided for the period 2015 through 2022. Also, ... data and analytics are derived from primary and secondary research. ...
Breaking Medicine Technology: