腹腔镜胃手术强化康复计划的结果

Outcomes From an Enhanced Recovery Program for Laparoscopic Gastric Surgery.

作者信息

Wong-Chong Nathalie, Kehlet Henrik, Grantcharov Teodor P

机构信息

*Department of Surgery, University of Toronto ‡Division of General Surgery, St. Michael's Hospital, Toronto, ON, Canada †Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark.

出版信息

Surg Laparosc Endosc Percutan Tech. 2016 Jun;26(3):e50-5. doi: 10.1097/SLE.0000000000000277.

DOI:10.1097/SLE.0000000000000277

PMID:27258917

Abstract

PURPOSE

To examine the outcomes from an enhanced recovery after surgery (ERAS) program for laparoscopic gastric surgery.

MATERIALS AND METHODS

This was a prospective study of patients undergoing elective laparoscopic gastric resection in an ERAS protocol at a single institution between 2008 and 2012. Outcomes included the length of hospital stay, intraoperative and postoperative complications, the readmission rate, the reoperation rate, and the 30-day mortality.

RESULTS

Of the 86 patients, 60 underwent partial gastrectomy and 26 underwent total gastrectomy. Median lymph nodes sampled was 15 (range, 9 to 47). The median length of hospital stay was 4 (range, 1 to 44) days. The conversion rate to open surgery was 11.6%. Four patients (4.7%) had an anastomotic leak. Three patients had postoperative bleeding (4.7%). About 4.7% (n=4) of the patients required readmission and 8.1% required reoperation (n=7). The 30-day mortality rate was 2.3% (n=2) due to complications from anastomotic leak.

CONCLUSIONS

Laparoscopic gastrectomy within an ERAS protocol results in a short hospital stay with an acceptable morbidity and mortality rate.

摘要

目的

研究腹腔镜胃手术加速康复外科（ERAS）方案的效果。

材料与方法

这是一项对2008年至2012年在单一机构按照ERAS方案接受择期腹腔镜胃切除术患者的前瞻性研究。结果包括住院时间、术中及术后并发症、再入院率、再次手术率和30天死亡率。

结果

86例患者中，60例行部分胃切除术，26例行全胃切除术。中位取样淋巴结数为15个（范围9至47个）。中位住院时间为4天（范围1至44天）。开腹手术转化率为11.6%。4例患者（4.7%）发生吻合口漏。3例患者发生术后出血（4.7%）。约4.7%（n = 4）的患者需要再次入院，8.1%的患者需要再次手术（n = 7）。由于吻合口漏并发症，30天死亡率为2.3%（n = 2）。