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RACS ASC 2024

Enhanced recovery after surgery for oncological breast surgery reduces length of stay in a resource limited setting

Poster

Poster

Disciplines

Breast Surgery

Presentation Description

Institution: Coffs Harbour Health Campus - NSW, Australia

Early recovery after surgery (ERAS) protocols in breast surgery optimises resources and reduces healthcare costs by facilitating early discharges. These protocols are well established in tertiary centres, but not commonly adopted in regional centres. ERAS implementation potentially impacts smaller hospitals significantly, where resources are limited and persistent bed shortages with mounting waitlist pressures exist. Our study evaluates the feasibility of early discharge with the application of our ERAS protocol to mastectomies in a resource-constrained and rural setting. Breast cancer patients who underwent mastectomies with or without reconstruction between January 2017 to July 2023 were reviewed. From January 2022, we implemented a standardised ERAS protocol for patients undergoing mastectomy. This incorporated a combination of pre-, intra- and post-operative elements to enhance patient readiness for discharge. Our study compared these patients (post-ERAS group) with the outcomes of mastectomies performed prior to January 2022 (pre-ERAS group). 104 patients were identified. In the post-ERAS group, 74.4% were discharged within 24 hours compared to 23.1% in the pre-ERAS group. Length of stay was reduced from 2.26 to 1.42 days. There were no differences in unplanned clinician reviews or early representation to the emergency department between the two groups. Reducing the length of stay without increased complications can be achieved in a resource-limited environment with our protocolised ERAS principals. Our protocol has been instrumental in allowing safe discharges within 24 hours. Other regional centres may benefit in adopting strategies implemented by us for their own ERAS protocols in breast cancer surgery.

Speakers

Authors

Authors

Dr Ernest Cheng - , Dr Jasmine Mui - , Dr Shehnarz Salindera -