757 European Enhanced Recovery After Surgery (ERAS) gynecological oncology survey: current state of perioperative practice

Introduction/Background* Enhanced Recovery After Surgery (ERAS) reduces complication rates after surgery, decreases length of hospital stay (LOS) and reduces costs. A correct implementation of the ERAS protocol and adherence to all ERAS items contribute to better outcomes in gynecological oncology surgery. The aim of this survey is to acquire a comprehensive picture of the current status of implementation of the ERAS protocol among European centers. Methodology A 45-item questionnaire survey, investigating ERAS practice preferences in pre-, intra-, and post-operative management was launched between December 2020 and May 2021. An on-line questionnaire link was e-mailed to the national representatives (NATREPs) of the European Network of Young gynecologic oncologists (ENYGO), who then shared the survey with their centers. In order to avoid duplicate data, NATREPs selected one referral person from the highest volume centers performing complex surgery per country. Two weeks later a reminder was sent to non-responders. Result(s)* A total of 116 responses were collected. 73% of centers were academic/teaching hospitals. Overall, 70% of respondents reported that ERAS was implemented at their institution. The median LOS for advanced ovarian cancer surgery was between 5-7 days according to 63% of respondents. 81% of respondents reported a median LOS between 2-4 days among patients who underwent surgery for early-stage gynecological cancer. An overall compliance rate between 60% and 80% was reported by 44,29% of centers. ERAS items with well adherence to the guidelines were: deep vein thrombosis prophylaxis, antibiotic prophylaxis, prevention of hypothermia and early mobilization. Regarding preoperative ERAS items, 28% of respondents reported bowel preparation as ‘sometimes–normally’ performed. 60% of respondents described ERAS implementation as a challenge and 76% reported being reluctant to change clinical practice. Conclusion* This European survey of ERAS in gynecologic oncology surgery shows that there is still a lack of implementation of the ERAS protocol across Europe and European centers need to increase ERAS gynecologic oncology guideline compliance to improve patient outcomes. Therefore, European centers need a further protocol and guidelines that encompass the way of ERAS implementation