Health-related Quality of Life after Laparoscopic Hysterectomy following Enhanced Recovery after Surgery Protocol or a Conventional Recovery Protocol

J Minim Invasive Gynecol. 2021 Sep;28(9):1650-1655. doi: 10.1016/j.jmig.2021.02.008. Epub 2021 Feb 11.


Study objective: To compare the health-related quality of life (HRQoL) and psychologic distress after laparoscopic hysterectomy (LH) following enhanced recovery after surgery (ERAS) and conventional recovery protocols.

Design: A secondary analysis of a single-center randomized controlled trial.

Setting: University hospital.

Patients: Women assigned to LH were randomly divided into 2 groups: intervention (ERAS protocol) group (IG) (n = 60) and control (conventional protocol) group (CG) (n = 60).

Interventions: Women in the intervention group (IG) were treated according to the ERAS protocol.

Measurements and main results: The primary outcome was a change in HRQoL assessed by the 15D questionnaire and a change in psychologic distress assessed by the General Health Questionnaire-12 at baseline before surgery and 1 month later. One month after surgery, the HRQoL was clinically and statistically better compared with baseline but with no difference between the groups. When following the ERAS protocol, the improvement in HRQoL was clinically greater, the difference in the dimension of sleeping was statistically better (p <.05), and the dimensions of discomfort and symptoms (+0.028), depression (+0.282), distress (+0.018), and vitality (+0.040) were clinically better than when following the conventional recovery protocol. No differences were found in the psychologic distress scores either preoperatively or 1 month after surgery (24 in IG vs 25 in CG [p = .85] and 9 in IG vs 12 in CG [p = .47], respectively).

Conclusion: The HRQoL improved after LH with no significant difference between the ERAS and conventional recovery protocols. However, clinically, the change in HRQoL was greater, and the dimensions of sleeping, discomfort and symptoms, depression, distress, and vitality were better when following ERAS. Psychologic distress was equal in both groups. ERAS seems to have a positive impact on recovery after LH.

Trial registration: NCT03828981.

Keywords: Enhanced recovery pathway; Gynecologic surgery; Psychological distress; Quality of life after hysterectomy.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Enhanced Recovery After Surgery*
  • Female
  • Humans
  • Hysterectomy / adverse effects
  • Laparoscopy*
  • Length of Stay
  • Quality of Life
  • Randomized Controlled Trials as Topic

Associated data