Enhanced Recovery after Surgery Protocol Optimizes Results and Cost of Laparoscopic Sacralcolpopexy

Background: The incidence of pelvic organ prolapse (POP) is high, and laparoscopic sacralcolpopexy (LSC) is considered the gold standard procedure for central pelvic defects. However, surgery can lead to postoperative stress response, postoperative pain, and discomfort related to catheters, thus affecting patients’ postoperative recovery. Numerous studies have shown that enhanced recovery after surgery (ERAS) protocols can alleviate stress response to varying degrees in gynecological surgical patients and improve postoperative recovery quality and satisfaction. However, the effectiveness of ERAS in LSC remains unclear. Methods: The clinical data of 38 patients with POP in the Department of Gynecology and Obstetrics of Renmin Hospital of Wuhan University from March 2022 to March 2023 were collected, including 19 patients in the ERAS group and 19 patients in the control group. The primary outcomes were postoperative hospital length of stay (LOS) and hospitalization costs. Secondary outcomes were 30-day readmission rate, postoperative complications, postoperative nausea and vomiting incidence, and VAS pain scores. Results: Compared with the control group, postoperative LOS was significantly shorter in the ERAS group (113.195 vs. 148.563 hours, p = 0.003). The hospitalization costs were also significantly lower in the ERAS group (41398.25 vs. 45548.04 yuan, p = 0.023). No 30-day readmission or reoperation occurred in either group. PONV occurred in one patient (5.26%) in the ERAS group and in eight patients (42.11%) in the control group. Compared with the control group, the ERAS group had earlier and shorter the first postoperative exhaust time and first postoperative off-bed activity time (p < 0.05). The overall rate of postoperative complications in the ERAS group was lower than that in the control group. The results of the POP quantification (POP-Q) score and the patient global impression of improvement (PGI-I) questionnaire conducted 30 days post-surgery indicate that both groups exhibited similar improvements in prolapse symptoms following the procedure. No significant differences were found between the two groups in the Visual Analogue Scale scores and the Quality of Postoperative Rehabilitation Scale scores. Conclusions: The implementation of the ERAS protocol for LSC provides significant advantages compared to traditional gynecological perioperative management. In this small study, improvements were observed in postoperative recovery time, a reduction in length of hospital stay, and lower hospital costs. We did not observe any increase in complications or risks in this small group of patients. Therefore, the ERAS protocol for LSC should be considered for widespread clinical use.