Effect of Enhanced Recovery After Surgery vs. Traditional Postoperative Care in Patients with Endometriosis: A Retrospective Cohort Study

Background: Enhanced Recovery After Surgery (ERAS) may improve recovery after bowel surgery for deep endometriosis, but disease-specific evidence remains limited. In this study, ERAS was compared with traditional care. Methods: This retrospective cohort included 150 women undergoing laparoscopic discoid excision or segmental resection at Avicenna Fertility Clinic, Tehran, from December 2020 to December 2021 (75 per group). Outcomes were hospital stay, return to activities, fever, and 30-day rehospitalization. Groups were compared with t-tests, chi-square tests, or Fisher exact tests. Crude odds ratios (ORs), risk differences (RDs), and 95% confidence intervals (CIs) were calculated. Results: Chief complaints differed between groups (p<0.001). ERAS was associated with discharge within 1-3 days (85.3% vs. 17.3%; RD, 68.0 percentage points; OR, 27.75; 95%CI, 11.56-66.61) and complete return to activities within 2 weeks (94.7% vs. 62.7%; RD, 32.0 points; OR, 10.57; 95%CI, 3.48-32.11). Fever (8.0% vs. 1.3%; OR, 6.43; 95%CI, 0.76-54.82) and rehospitalization (4.0% vs. 1.3%; OR, 3.08; 95%CI, 0.31-30.34) were not significantly different. Conclusion: These findings are suggestive rather than causal and require confirmation in prospective multicenter studies with verified adjusted analyses and longer follow-up.