Enhanced recovery after posterior deep infiltrating endometriosis surgery: a national study

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Audrey Pivano, M.D., Vanessa Pauly, Ph.D., Nicolas Pirro, M.D., Ph.D., Marine Alessandrini, M.D., Laurent Boyer, M.D., Ph.D., Pascal Auquier, M.D., Ph.D., Aubert Agostini, M.D., Ph.D.



To evaluate the impact of the implementation of a national enhanced recovery after surgery (ERAS) program for posterior deep infiltrating endometriosis (DIE) surgery on the length of hospital stay, the rate of postoperative complications, and readmission within 30 days.


Comparative exposed/nonexposed observational study.


Study based on the French national medicoeconomic database of the Program of Medicalization of Information System.


Seven hundred and sixty-four women who underwent DIE surgery were involved and matched (1:3 ratio) into two groups: ERAS group for the year 2019 and non-ERAS group for the year 2015.


Surgical management for posterior DIE.

Main Outcome Measures

The length of hospital stay, the rate of postoperative complications during the initial hospital stay, and readmission within 30 days.


The ERAS group included 191 women, and the non-ERAS group included 573 women. The mean length of hospital stay was shorter in the ERAS group than in the non-ERAS group (4.28 ± 3.80 days vs. 5.42 ± 4.04 days, respectively). The rate of postoperative abdominal or pelvic pain syndromes was lower in the ERAS group than in the non-ERAS group (5/191 (2.62%) vs. 48/573 (8.38%), respectively; relative risk, 0.31 [0.125–0.7969]). The rate of postoperative complication and the rate of readmission within 30 days were not different between the two groups.


The implementation of ERAS has a significant positive impact on patient outcomes after DIE surgery. The length of hospital stay and abdominal or pelvic pain syndromes were reduced without increasing complications or readmission within 30 days.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.