591 Perioperative care in gynaecological cancer surgery during the COVID pandemic in a low resource centre – role of enhanced recovery protocols

Abstract

Introduction/Background ∗ ERAS (Enhanced Recovery after Surgery) is a multimodal perioperative care pathway designed to achieve early recovery after surgical procedures. This study aimed to analyse the feasibility of ERAS in the era of pandemic and to find its effect on the post-operative outcome of patients undergoing surgery for gynaecological cancer during the COVID pandemic Methodology This observational study was done on patients who underwent gynaecological cancer surgery during COVID pandemic in a tertiary cancer centre in South India. Data was collected including patient demographics, nature of surgery, adherence to each of the components of ERAS programme and outcomes. Post operative complications were graded according to the Clavien-Dindo classification Result(s)∗ 152 patients were included in the study period from June to December 2020. 85 patients had cancer ovary, 59 cancer endometrium, 6 cancer cervix and 1 cancer vulva and 7 patients had benign tumours. In the pre operative component of ERAS protocols,82% patients received pre surgery counselling, 97% received thromboembolic prophylaxis, 94% received carbohydrate loading and none of the patients received mechanical bowel preparation. 8% received blood components during and after surgery. In the post operative phase on Day 1, 62% patients had urinary catheter removed, 88% received normal diet and 92% had early ambulation. The complication rate was 26%, but majority 79% had grade 1 and 2 complications. There was one postoperative mortality due to sepsis. The mean hospital stay was 6.6 days. Conclusion∗ The study confirms the feasibility and benefits of following ERAS pathway in enhancing patient recovery during COVID pandemic.