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Enhanced Recovery After Surgery (ERAS)

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Cagney
Enhanced Recovery After Surgery (ERAS)

Saw the consultant today, signed the consent form for the hysterectomy. She's ticked hysterectomy and also Other and written ERAS. Which I looked up and it means Enhanced Recovery After Surgery.

I wondered if anyone has any experience of ERAS? What did it entail? I'm having abdominal surgery so it's not going to be the operation that's part of it - i.e. not keyhole or vaginal. And general anaesthetic, not epidural. So I'm wondering what else it might involve?

High grade CIN and CGIN, endocervical adenocarcinoma grade 2 stage 1.

Abdominal hysterectomy BSO 30 Dec 2020.

Shewolf

https://www.nhs.uk/conditions/enhanced-recovery/

1/16Vaginal bleeding

12/16Stage 2b

Jan-Mar 2017 35 EBR 5 x Cisplatin

6/17 All clear

12/17 2.5cm tumour,incurable

3/18 7 x carbo/Taxol/Avastin

8/18 MRI CT-PET cancer free.3 Carbo/Avastin 11/18 remission

4/19 15mm endocervix recurrence

7/19 -8/19 5 x SABRE LINAC

11/19 MRI- treated area stable,but tumour growth at uterine fundus and full thickness of myometrium.

Surgical opinion 4/12/19 laparoscopy cancelled 27/1/2020 CT PET tumour 12.5cm,no mets possible Pagets disease. Surgery ruled out 28/1/2020 Biopsies taken

2/2020 started 6 cycles of Doxirubicin and carboplatin

7/20 tumour active again. Platinum resistant. No further treatment availabile. 

Cagney

Thanks Shewolf, I saw that info but just wondered if anyone has first hand experience. 

High grade CIN and CGIN, endocervical adenocarcinoma grade 2 stage 1.

Abdominal hysterectomy BSO 30 Dec 2020.

Jazza
Jazza's picture

Hi

I was given a leaflet by my medical team, prior to my surgery, about enhanced recovery.  From memory I recall it including a carbohydrate drink (powder in a sachet to make up with water) to take the night before surgery and also before 6am on the day of the surgery; the drink was referred to as a 'preload' - in a nutshell it's purpose is to generally aid recovery.  The programme also included the wearing of surgical stockings to help reduce the risk of blood clots; I had daily blood thinning injections after the surgery again to help prevent blood clots.  The morning after my surgery (mine was keyhole) and immediately after breakfast a healthcare assistant appeared to get me up and walking asap and then to keep moving as much as possible.  There was also quite a lot of commonsense things in the leaflet like getting up to date with housework, arranging for care of pets etc etc prior to surgery.  Perhaps you should have been given a leaflet about it - maybe check with your CNS.

x

  • Feb 04:  (age 47y) Smear test normal
  • Stopped going for smears!
  • Summer 16: persistent watery yellow vaginal discharge
  • Dec 16: PMB
  • Jan 17: Hysteroscopy under GA for ?fibroids - abnormal cervix observed -multiple biopsies taken, 1B1 (1B2 on new FIGO) squamous cell cc diagnosed - confirmed by MRI/PET scans
  • Feb 17: pelvic lymphadenectomy - nodes negative, Da Vinci radical hysterectomy- close anterior margin/LVSI/PNI, restaged to 2A1 (2A1 on new FIGO)
  • Apr/May 17: 6 chemo, 25 external radio, 2 brachy
  • May 20:  NED.  Side effects notably hypotonic bladder since hysterectomy - ongoing ISC, unilateral lymphoedema lower abdo/groin/leg/ankle/foot
FeelingTheFear

Hi,

I was on an ERAS program for my abdominal hysterectomy. Like Jazza said, a lot of it was just what seemed to me to be common sense, so you get back to some kind of normal functioning as soon as possibke, which reduces the stress on the body and helps get you home faster e.g. clear liquids can be consumed up to 2hr before, getting out of bed ASAP the day after surgery, encouraging normal eating, showering and walking, removing the catheter ASAP, etc

This contrasts with previous approaches to surgery where bed rest was considered necessary (subsequently found to increase risks of DVT), along with enema/bowel prep (stressful/miserable), prolonged fasting prior to GA (stressful/miserable), prolonged resting of the bladder with catheter (can cause irritation/cystitis), avoiding solid foods to rest the gut (again stressful/miserable). 

I would recommend ERAS even though it is pretty much a fancy word for some common sense measures :-)

Feb 2020: smear = high grade dyskariosis

March 2020: biopsy = CIN3

April 2020: lletz = cervical cancer stage 1b1 (1b2 on new FIGO)

May 2020: radical hysterectomy and lymphadenectomy. NED!

September 2020: first follow up. NED!

Cagney

thank you Jazza and FealingTheFear - useful to know what you experienced. I haven't been given any details, though the Dr did mention getting the catheter out after the first day and getting me walking right away, so jolly good, I'm up for that. 

High grade CIN and CGIN, endocervical adenocarcinoma grade 2 stage 1.

Abdominal hysterectomy BSO 30 Dec 2020.

More Information

Treatments for cervical cancer