Sánchez-Urdazpal González Luis, Salido Fernández Sergio, Alday Muñoz Enrique, Gómez Martín-Tesorero Lourdes, Molina Baena Begoña
Servicio de Cirugía. H.U. de la Princesa..
Servicio de Cirugía. Hospital General de Villalba..
Nutr Hosp. 2015 May 7;31 Suppl 5:16-29. doi: 10.3305/nh.2015.31.sup5.9128.
The perioperative management of patients undergoing abdominal surgery has been based on traditional concepts and often not supported by scientific evidence. Recently there have been several scientific studies showing that some traditional procedures for the perioperative management of patients as preoperative fasting, bowel preparation, use of naso-gastric tubes, placement of intra-abdominal drainage, postoperative fasting etc. They are unnecessary and sometimes counterproductive. Perioperative management protocols ERAS or Fast-Track (Enhanced Recovery After Surgery) are based on the use in the perioperative period of measures that are supported by current scientific evidence. Since 2000 appear in the scientific literature several works that reflect the application of protocols ERAS or Fast- Track in surgery of the digestive system where it's shown uniformly, not only the security of your application but also, decreased complications and hospital stay. Although initially these protocols were described in colorectal surgery, due to the good results obtained, the application of these protocols has rapidly expanded to other surgical specialties such as thoracic surgery, Urology, Gynaecology, etc. In all these specialties has unanimously showing improved postoperative recovery with ERAS application protocols. The purpose of this paper is twofold. On the one hand examine the scientific evidence that exists today on the most important elements of an ERAS program and present preliminary results of the implementation of a program ERAS in our hospital.
腹部手术患者的围手术期管理一直基于传统观念,且往往缺乏科学证据支持。最近有多项科学研究表明,一些传统的患者围手术期管理程序,如术前禁食、肠道准备、使用鼻胃管、放置腹腔引流管、术后禁食等,是不必要的,有时甚至适得其反。围手术期管理方案ERAS或快速康复(术后加速康复)基于围手术期采用当前科学证据支持的措施。自2000年以来,科学文献中出现了几篇反映ERAS或快速康复方案在消化系统手术中应用的著作,这些著作一致表明,该方案不仅应用安全,而且能减少并发症和缩短住院时间。尽管最初这些方案是在结直肠手术中描述的,但由于取得了良好效果,这些方案的应用已迅速扩展到其他外科专科,如胸外科、泌尿外科、妇科等。在所有这些专科中,应用ERAS方案均一致显示术后恢复得到改善。本文目的有两个。一方面,研究目前关于ERAS方案最重要要素的科学证据,并展示我院实施ERAS方案的初步结果。