# Enhanced recovery after gynaecological cancer surgery (ERAS pathway for gynaecologic oncology)

Source: https://onco.cc/protocols/enhanced-recovery-after-gynaecological-cancer-surgery/  
OnCo record `enhanced-recovery-after-gynaecological-cancer-surgery` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

After an operation for ovarian, womb or cervical cancer, enhanced recovery means eating a normal diet and getting up within a day, the drip and the urinary catheter out within a day, no routine drains, pain relief that relies less on opioids, and four weeks of blood clot injections after open surgery for cancer.

## Summary

The ERAS Society has updated its gynecologic oncology guideline three times (2019, 2023 implementation update, 2026), but none of the updates is open and their abstracts state no recommendations. The latest edition whose recommendations could be read is the 2016 Part II on postoperative care (GRADE): compression stockings and intermittent pneumatic compression, and 28 days of extended prophylaxis after laparotomy for abdominal or pelvic cancer (high, strong); IV fluids stopped within 24 hours with balanced crystalloid (moderate, strong); a regular diet within 24 hours (high, strong); multimodal analgesia with regular paracetamol and an NSAID (high, strong); spinal anaesthesia with intrathecal morphine for open surgery (moderate, strong), with thoracic epidural an alternative (high, strong) and a TAP block where there is no neuraxial block (moderate, strong); no routine peritoneal drain, even after lymphadenectomy or bowel surgery (moderate, strong); urinary catheter out within 24 hours (low, strong); mobilisation within 24 hours (low, strong); laxatives and chewing gum to be considered (weak). NICE NG180 offers an enhanced recovery programme for all elective major surgery and allows clear fluids to 2 hours before.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: ERAS gynaecologic oncology; ERAS gynecologic oncology; enhanced recovery hysterectomy; enhanced recovery ovarian cancer surgery; perioperative care for gynaecological cancer

## Connected records

- protocols: [Blood clot prevention around cancer surgery, including extended prophylaxis after major abdominal and pelvic operations](https://onco.cc/protocols/vte-prophylaxis-after-cancer-surgery/), [Enhanced recovery after colorectal cancer surgery (ERAS pathway for bowel resection)](https://onco.cc/protocols/enhanced-recovery-after-colorectal-surgery/), [Routine tests before planned surgery, by size of operation and fitness](https://onco.cc/protocols/routine-preoperative-tests/), [Surgical site infection prevention: skin preparation, antibiotic timing, warming and wound care](https://onco.cc/protocols/surgical-site-infection-prevention/)
- cancers: [Cervical cancer](https://onco.cc/cancers/cervical/), [Endometrial cancer](https://onco.cc/cancers/endometrial/), [Ovarian cancer](https://onco.cc/cancers/ovarian/), [Vulvar cancer](https://onco.cc/cancers/vulvar/)
- technologies: [Enhanced recovery (ERAS) and perioperative nutrition](https://onco.cc/technologies/eras-perioperative-nutrition/), [Prehabilitation before cancer surgery](https://onco.cc/technologies/prehabilitation/)
- terms: [Debulking (cytoreductive surgery)](https://onco.cc/terms/debulking/), [Hysterectomy](https://onco.cc/terms/hysterectomy/), [Prehabilitation (the pre-treatment window)](https://onco.cc/terms/prehabilitation-term/)
- ideas: [Enhanced recovery after cancer surgery, with each element's compliance measured and fed back](https://onco.cc/ideas/idea-pu-enhanced-recovery-with-measured-compliance/), [Four weeks of blood-clot prevention after major abdominal or pelvic cancer surgery](https://onco.cc/ideas/idea-pu-extended-clot-prevention-after-surgery/)

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