手术加速康复方案对接受常规肝切除术患者术后发病率和死亡率的影响：当前证据综述
Impact of enhanced recovery after surgery protocols on postoperative morbidity and mortality in patients undergoing routine hepatectomy: review of the current evidence.
作者信息
Damania Rahul, Cocieru Andrei
机构信息
Northeastern Ohio Medical University, Rootstown, OH, USA.
Department of Surgery, Akron City Hospital, Akron, OH, USA.
出版信息
Ann Transl Med. 2017 Sep;5(17):341. doi: 10.21037/atm.2017.07.04.
BACKGROUND
Enhanced recovery protocols are widely used in many areas of general surgery but had a limited penetration in perioperative management of patients undergoing liver resection. Recently, multiple publications described application of enhanced recovery after surgery (ERAS) program to hepatectomy patients but their definitive role is not established or accepted by hepatobiliary surgeons.
METHODS
A comprehensive literature review of published series in English language medical sources detailing ERAS program application for hepatectomy for the period of 2006-2016 is performed.
RESULTS
ERAS protocols are feasible and safe. They reduce length of stay in patients undergoing routine hepatectomy without negative impact on morbidity and mortality. There is potential for reduction of Clavien grade I-II complications, while major and surgical complications are similar to traditional care management group.
CONCLUSIONS
Application of ERAS program to patient undergoing hepatectomy reduces length of hospital stay without affecting perioperative morbidity or mortality and may represent a new standard of care for patients undergoing routine liver resection.
背景
加速康复方案在普通外科的许多领域广泛应用，但在肝切除患者围手术期管理中的应用有限。最近，多篇文献描述了术后加速康复（ERAS）方案在肝切除患者中的应用，但其确切作用尚未得到肝胆外科医生的确立或认可。
方法
对2006年至2016年期间英文医学文献中详述ERAS方案在肝切除术中应用的已发表系列进行全面文献综述。
结果
ERAS方案可行且安全。它们缩短了接受常规肝切除术患者的住院时间，且对发病率和死亡率无负面影响。有降低Clavien I-II级并发症的可能性，而严重和手术并发症与传统护理管理组相似。
结论
将ERAS方案应用于肝切除患者可缩短住院时间，而不影响围手术期发病率或死亡率，可能代表常规肝切除患者的一种新的护理标准。
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