尽管有支持其使用的证据，但许多增强恢复术后（ERAS）建议仍未得到很好的遵守，ERAS实施的障碍仍然存在。在这个第二次更新的ERAS®学会指南中，提出了妇科肿瘤手术围手术期最佳护理的共识，重点强调了实施挑战。根据临床利益相关者小组确定的差距，优先选择了九个实施挑战主题进行审查。执行Embase和PubMed数据库搜索（2018-2023）。选择了每个主题的研究，重点是荟萃分析，随机对照试验和大型前瞻性队列研究。然后，国际专家组根据推荐、评估、开发和评估（GRADE）系统对这些研究进行审查和评分。关于ERAS实施挑战主题的所有建议都基于最佳可用证据。每个项目的证据级别相应地呈现。ERAS®学会在这个共识审查中介绍了妇科肿瘤利益相关者衍生的ERAS实施挑战的更新证据基础和建议。版权所有©2023作者。由Elsevier Inc.发布。保留所有权利。

Despite evidence supporting its use, many Enhanced Recovery After Surgery (ERAS) recommendations remain poorly adhered to and barriers to ERAS implementation persist. In this second updated ERAS® Society guideline, a consensus for optimal perioperative care in gynecologic oncology surgery is presented, with a specific emphasis on implementation challenges.Based on the gaps identified by clinician stakeholder groups, nine implementation challenge topics were prioritized for review. A database search of publications using Embase and PubMed was performed (2018-2023). Studies on each topic were selected with emphasis on meta-analyses, randomized controlled trials, and large prospective cohort studies. These studies were then reviewed and graded by an international panel according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.All recommendations on ERAS implementation challenge topics are based on best available evidence. The level of evidence for each item is presented accordingly.The updated evidence base and recommendations for stakeholder derived ERAS implementation challenges in gynecologic oncology are presented by the ERAS® Society in this consensus review.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.