Application of enhanced recovery after surgery in perioperative management of patients undergoing laparoscopic surgery for benign gynecological conditions

This study evaluates the effectiveness of enhanced recovery after surgery (ERAS) protocol in laparoscopic gynecological surgery and its impact on perioperative management. A retrospective analysis was conducted on 187 patients who underwent elective laparoscopic gynecological surgery at Guangyuan Central Hospital between November 2022 and December 2023. Of these, 92 patients were enrolled in the ERAS group, and 95 were assigned to the conventional care group. The ERAS protocol included evidence-based interventions such as shortened fasting duration, carbohydrate loading, avoidance of mechanical bowel preparation, and early postoperative mobilization. Primary endpoints included stress response markers (serum cortisol, homeostatic model assessment of insulin resistance), nutritional parameters (prealbumin, albumin, blood urea nitrogen), and clinical outcomes (time to gastrointestinal recovery, length of hospital stay). Secondary endpoints comprised postoperative complications, healthcare costs, and patient satisfaction. The ERAS group showed significantly faster gastrointestinal recovery (first flatus: 15.54 ± 1.73 vs 21.24 ± 3.53 hours, P < .001), shorter hospitalization (4.91 ± 0.90 vs 6.29 ± 1.25 days, P < .001), and lower healthcare costs (13,960 ± 1967 vs 15,270 ± 2856 yuan, P < .001). Postoperative stress response was reduced (cortisol, P = .012), and nutritional parameters were better preserved (P < .001). Patient satisfaction was higher in the ERAS group (100% vs 96.8%, P = .042). The ERAS protocol significantly optimizes perioperative management for patients undergoing laparoscopic gynecological surgery, reducing hospital stay, lowering complication rates, and enhancing patient satisfaction, thus providing robust evidence for clinical implementation. However, further research is needed to explore its long-term effects.