Aplicación de un protocolo ERAS (enhanced recovery after surgery) para la práctica cirugía oncológica compleja de la mama en régimen ambulatorio

Introduction

Outpatient mastectomies and lymphadenectomies are not routinely performed in Europe, probably because there are no specific protocols for their correct implementation. The objective of our study is to demonstrate that with the application of an ERAS protocol, complex oncological surgery of the breast can be performed on an outpatient basis in an effective, efficacious and efficient manner.

Methods

Prospective observational study including all patients who underwent mastectomy, sentinel node mastectomy, lumpectomy with axillary lymphadenectomy, and mastectomy with axillary lymphadenectomy from September 2018 to September 2021. We evaluated the success rate, admission rate not expected, readmission rate, frequenting the emergency room, telephone consultations, complications and degree of patient satisfaction.

Results

A total of 89 patients are included. The success rate was 94.4%. The unexpected admission rate was 5% (5 patients). The reasons for unexpected admission were: nausea and vomiting in 3, pain in 1, and wound bruising in 1. The rate of visits to the emergency room and telephone consultations was 3.4%. The complications were the same as if they had been admitted. 97.6% would recommend the process to a relative or friend of theirs.

Conclusion

The implementation of a specific ERAS pathway allows outpatient mastectomies and lymphadenectomies in an effective, safe and efficient manner, allowing the patient to accept the process with a high degree of satisfaction.