旨在比较实施加速康复外科（ERAS）方案前后因妇科恶性肿瘤接受盆腔廓清术的患者的围手术期结果。我们对之前（2006年1月1日至12日）因妇科恶性肿瘤接受盆腔廓清术的患者进行了一项机构回顾性队列研究。 /30/2014）及之后（1/1/2015-6/30/2023）实施 ERAS。我们描述了 ERAS 合规率。我们比较了切除后 60 天的结果。并发症等级由 Clavien-Dindo 系统定义。总共有 105 名女性接受了盆腔廓清术； ERAS 前队列中有 74 例 (70.4%)，ERAS 队列中有 31 例 (29.5%)。队列之间在年龄、体重指数、种族、原发疾病部位、切除类型、尿流改道或阴道重建方面没有差异。所有患者均出现并发症，其中 94.6% 的 ERAS 前患者和 90.3% 的 ERAS 患者至少出现一种 II 级并发症。 ERAS 队列中 I-II 级胃肠道（61.3% vs 21.6%，p < 0.001）和血液学（61.3% vs 36.5%，p = 0.030）和 III-IV 级肾病（29.0% vs 12.2%，p = 0.048）较多）和伤口并发症（45.2% vs 18.9%，p = 0.008）与 ERAS 前队列相比。 ERAS 患者的肠梗阻（38.7% vs 10.8%，p = 0.002）、尿漏（22.6% vs 5.4%，p = 0.014）、盆腔脓肿（35.5% vs 10.8%，p = 0.005）、术后出血发生率较高需要干预（61.3% vs 28.4%，p = 0.002）和重新入院（71.4% vs 46.5%，p = 0.025）。 ERAS 依从性中位数为 60%。盆腔廓清术仍然是一种病态手术，与 ERAS 之前的队列相比，ERAS 中的并发症更常见。与标准妇科肿瘤 ERAS 途径相比，ERAS 方案应根据盆腔廓清术的复杂性进行优化和定制。版权所有 © 2024 Elsevier Inc. 保留所有权利。

To compare perioperative outcomes in patients undergoing pelvic exenteration for gynecologic malignancies before and after implementation of Enhanced Recovery After Surgery (ERAS) protocols.We performed an institutional retrospective cohort study of patients undergoing pelvic exenteration for gynecologic malignancies before (1/1/2006-12/30/2014) and after (1/1/2015-6/30/2023) ERAS implementation. We described ERAS compliance rates. We compared outcomes up to 60 days post-exenteration. Complication grades were defined by the Clavien-Dindo system.Overall, 105 women underwent pelvic exenteration; 74 (70.4%) in the pre-ERAS and 31 (29.5%) in the ERAS cohorts. There were no differences between cohorts in age, body mass index, race, primary disease site, type of exenteration, urinary diversion, or vaginal reconstruction. All patients had complications, with at least one grade II+ complication in 94.6% of pre-ERAS and 90.3% of ERAS patients. The ERAS cohort had more grade I-II gastrointestinal (61.3% vs 21.6%, p < 0.001) and hematologic (61.3% vs 36.5%, p = 0.030) and grade III-IV renal (29.0% vs 12.2%, p = 0.048) and wound (45.2% vs 18.9%, p = 0.008) complications compared to the pre-ERAS cohort. ERAS patients had a higher rate of ileus (38.7% vs 10.8%, p = 0.002), urinary leak (22.6% vs 5.4%, p = 0.014), pelvic abscess (35.5% vs 10.8%, p = 0.005), postoperative bleeding requiring intervention (61.3% vs 28.4%, p = 0.002), and readmission (71.4% vs 46.5%, p = 0.025). Median ERAS compliance was 60%.Pelvic exenteration remains a morbid procedure, and complications were more common in ERAS compared to pre-ERAS cohorts. ERAS protocols should be optimized and tailored to the complexity of pelvic exenteration compared to standard gynecologic oncology ERAS pathways.Copyright © 2024 Elsevier Inc. All rights reserved.