Gregg Nelson, Alon D. Altman, Amy Metcalfe, Christina Fotopoulou, Jolyn Taylor, G. Glaser, Jamie Bakkum-Gamez, Amanika Kumar, Larissa A. Meyer, R. Stone, Gabriel Mena, Kevin M. Elias, Steven P. Bisch, Oliver Zivanovic, Ester Miralpeix, Geetu Bhandoria, Ane Gerda Zahl Eriksson, Shannon M. Ruzycki, Pervez Sultan, Khara M. Sauro, Lindsay Blake, Mary E. Brindle, Pedro T. Ramirez, Sean C. Dowdy
BACKGROUND: This is the third updated enhanced recovery after surgery (ERAS®) society guideline presenting a consensus for optimal perioperative care in gynecologic oncology surgery. METHODS: A database search of publications using Embase and PubMed was performed (2018-2025). Studies for key elements within the ERAS gynecologic oncology protocol were selected with emphasis on meta-analyses, randomized controlled trials, and large prospective cohort studies. These studies were then reviewed and graded according to the grading of recommendations, assessment, development and evaluation (GRADE) system. RESULTS: All recommendations on ERAS protocol items are based on best available evidence. The level of evidence for each item is presented accordingly. CONCLUSIONS: The updated evidence base and recommendation for items within the ERAS gynecologic oncology perioperative care pathway are presented by the ERAS® society in this consensus review. Gynecologic surgeons may consider incorporating these recommendations into perioperative pathway design, with efforts to achieve consensus within their practice where feasible.