The standard for a patient’s hospital stay after ovarian cancer surgery used to be ten days to up to two weeks, but that has now changed. “With modern medicine, with programs that we call ERAS, which are enhanced recovery programs, a lot of our patients even when they’ve had radical operations are home and out of the hospital within five to seven days,” says Dr. Elizabeth Jewell, Gynecologic Surgeon at Memorial Sloan-Kettering Cancer Center.
The real progress in this field that has allowed patients to recover and get home sooner than they used to is in enhanced recovery after surgery, or ERAS for short. First used by Professor Henrik Kehlet in the 90s, these programs basically put patients on a fast track, and have been used in many different types of surgery to speed up the recovery process.
ERAS, if effectively implemented, can have salubrious effects across the board for ovarian cancer patients: improving their chances of long term recovery by getting them out of a hospital environment; allowing them to convalesce at home; sparing them from added risk of in-hospital infection and saving them a considering sum of money from mounting hospital bills which increase markedly with each additional night of residence.
ERAS focus on modifying the physiological and psychological responses to surgery and have shown reductions in complications post surgery, improvements in cardiopulmonary function, proper bowel function, and an earlier return to normal activities. A study on ERAS conducted by Megan Melynk, Rowan G. Casey, Peter Black, and Anthony J. Koupparis published in The Canadian Urological Association Journal states, “The key principles of the ERAS protocol include pre-operative counseling, preoperative nutrition, avoidance of perioperative fasting and carbohydrate loading up to 2 hours preoperatively, standardized anesthetic and analgesic regimens (epidural and non-opiod analgesia) and early mobilization.”
The pre-operative counseling allows the patients to mentally prepare themselves for the operation with the help of mental health professionals, while the preoperative nutrition and carbohydrate loading 2 hours prior to surgery allows the patient to be physically prepared for surgery. All of this is done to prepare the patient for surgery, while the post operation measures, like early mobilization allows the patient to recuperate even faster.
The economic benefits for a shorter stay are quite obvious too. The lesser time spent in the hospital, the less a patient or her medical care insurer will have to pay. According to the previously mentioned study, this has led to an overall cost saving of roughly $6,900 per patient.
“As we really learn the tricks of the trade, you will, their time in the hospital is decreasing, their quality of life is improving—whether that be pain management, quick ambulation after operation—and very few patients really have bad experiences. Most of my patients come back and say to me ‘that was not as bad as I thought it would be,” says Dr. Jewell. Through these modern advances patients can get home quicker and get back to their normal lives.
Furthermore, the more quickly a patient can leave the hospital, the less likely she is to be at risk for infections and other complications that can come from a hospital stay, even at the country’s finest institutions. As holding places for numerous sick people, hospitals are naturally a place where infections can be transmitted despite the best efforts of doctors, nurses, orderlies and other hospital personnel.
A prompt release from the hospital can also increase the mental health of a patient, raising the prospect for a better long term recovery. Many patients prefer to convalesce at home with their loved ones instead of at a hospital, and an improved environment can contribute to overall healing.
Learn more about SurvivorNet's rigorous medical review process.
Dr. Elizabeth Jewell is a gynecologic oncologist and surgeon at Memorial Sloan Kettering Cancer Center. She is also the Director of Surgery at MSK Monmouth and MSK Basking Ridge in New Jersey. Read More
The standard for a patient’s hospital stay after ovarian cancer surgery used to be ten days to up to two weeks, but that has now changed. “With modern medicine, with programs that we call ERAS, which are enhanced recovery programs, a lot of our patients even when they’ve had radical operations are home and out of the hospital within five to seven days,” says Dr. Elizabeth Jewell, Gynecologic Surgeon at Memorial Sloan-Kettering Cancer Center.
The real progress in this field that has allowed patients to recover and get home sooner than they used to is in enhanced recovery after surgery, or ERAS for short. First used by Professor Henrik Kehlet in the 90s, these programs basically put patients on a fast track, and have been used in many different types of surgery to speed up the recovery process.
READ MORE
ERAS, if effectively implemented, can have salubrious effects across the board for ovarian cancer patients: improving their chances of long term recovery by getting them out of a hospital environment; allowing them to convalesce at home; sparing them from added risk of in-hospital infection and saving them a considering sum of money from mounting hospital bills which increase markedly with each additional night of residence.
ERAS focus on modifying the physiological and psychological responses to surgery and have shown reductions in complications post surgery, improvements in cardiopulmonary function, proper bowel function, and an earlier return to normal activities. A study on ERAS conducted by Megan Melynk, Rowan G. Casey, Peter Black, and Anthony J. Koupparis published in The Canadian Urological Association Journal states, “The key principles of the ERAS protocol include pre-operative counseling, preoperative nutrition, avoidance of perioperative fasting and carbohydrate loading up to 2 hours preoperatively, standardized anesthetic and analgesic regimens (epidural and non-opiod analgesia) and early mobilization.”
The pre-operative counseling allows the patients to mentally prepare themselves for the operation with the help of mental health professionals, while the preoperative nutrition and carbohydrate loading 2 hours prior to surgery allows the patient to be physically prepared for surgery. All of this is done to prepare the patient for surgery, while the post operation measures, like early mobilization allows the patient to recuperate even faster.
The economic benefits for a shorter stay are quite obvious too. The lesser time spent in the hospital, the less a patient or her medical care insurer will have to pay. According to the previously mentioned study, this has led to an overall cost saving of roughly $6,900 per patient.
“As we really learn the tricks of the trade, you will, their time in the hospital is decreasing, their quality of life is improving—whether that be pain management, quick ambulation after operation—and very few patients really have bad experiences. Most of my patients come back and say to me ‘that was not as bad as I thought it would be,” says Dr. Jewell. Through these modern advances patients can get home quicker and get back to their normal lives.
Furthermore, the more quickly a patient can leave the hospital, the less likely she is to be at risk for infections and other complications that can come from a hospital stay, even at the country’s finest institutions. As holding places for numerous sick people, hospitals are naturally a place where infections can be transmitted despite the best efforts of doctors, nurses, orderlies and other hospital personnel.
A prompt release from the hospital can also increase the mental health of a patient, raising the prospect for a better long term recovery. Many patients prefer to convalesce at home with their loved ones instead of at a hospital, and an improved environment can contribute to overall healing.
Learn more about SurvivorNet's rigorous medical review process.
Dr. Elizabeth Jewell is a gynecologic oncologist and surgeon at Memorial Sloan Kettering Cancer Center. She is also the Director of Surgery at MSK Monmouth and MSK Basking Ridge in New Jersey. Read More
