Objective

To evaluate the impact of the implementation of a national enhanced recovery after surgery (ERAS) program for posterior deep infiltrating endometriosis (DIE) surgery on the length of hospital stay, the rate of postoperative complications, and readmission within 30 days.

Design

Comparative exposed/nonexposed observational study.

Setting

Study based on the French national medicoeconomic database of the Program of Medicalization of Information System.

Patients

Seven hundred and sixty-four women who underwent DIE surgery were involved and matched (1:3 ratio) into two groups: ERAS group for the year 2019 and non-ERAS group for the year 2015.

Interventions

Surgical management for posterior DIE.

Main Outcome Measures

The length of hospital stay, the rate of postoperative complications during the initial hospital stay, and readmission within 30 days.

Results

The ERAS group included 191 women, and the non-ERAS group included 573 women. The mean length of hospital stay was shorter in the ERAS group than in the non-ERAS group (4.28 ± 3.80 days vs. 5.42 ± 4.04 days, respectively). The rate of postoperative abdominal or pelvic pain syndromes was lower in the ERAS group than in the non-ERAS group (5/191 (2.62%) vs. 48/573 (8.38%), respectively; relative risk, 0.31 [0.125–0.7969]). The rate of postoperative complication and the rate of readmission within 30 days were not different between the two groups.

Conclusions

The implementation of ERAS has a significant positive impact on patient outcomes after DIE surgery. The length of hospital stay and abdominal or pelvic pain syndromes were reduced without increasing complications or readmission within 30 days.

中文翻译：

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后深部浸润性子宫内膜异位症手术后加速恢复：一项全国性研究

客观的

评估实施后深部浸润性子宫内膜异位症 (DIE) 手术的国家加速康复 (ERAS) 计划对住院时间、术后并发症发生率和 30 天内再入院的影响。

设计

比较暴露/非暴露观察研究。

环境

基于法国国家医学经济数据库的信息系统医学化计划研究。

耐心

764 名接受 DIE 手术的女性参与并匹配（1:3 比例）分为两组：2019 年的 ERAS 组和 2015 年的非 ERAS 组。

干预措施

后路 DIE 的手术治疗。

主要观察指标

住院时间、初次住院期间的术后并发症发生率以及 30 天内的再入院率。

结果

ERAS 组包括 191 名女性，非 ERAS 组包括 573 名女性。ERAS 组的平均住院时间短于非 ERAS 组（分别为 4.28 ± 3.80 天和 5.42 ± 4.04 天）。ERAS 组术后腹部或盆腔疼痛综合征的发生率低于非 ERAS 组（分别为 5/191（2.62%）和 48/573（8.38%）；相对风险，0.31 [0.125–0.7969 ]）。两组术后并发症发生率和30天内再入院率无差异。

结论

ERAS 的实施对 DIE 手术后的患者预后具有显着的积极影响。住院时间和腹部或骨盆疼痛综合征在 30 天内减少，但未增加并发症或再入院。