Bater M, King W, Teare J, D'Souza J
Maxillofacial Unit, Royal Surrey County Hospital, Guildford, Surrey, GU2 7XX, UK.
Anaesthetic Department, Royal Surrey County Hospital, Guildford, Surrey, GU2 7XX, UK.
Br J Oral Maxillofac Surg. 2017 Dec;55(10):1024-1029. doi: 10.1016/j.bjoms.2017.10.012. Epub 2017 Nov 21.
Programmes for Enhanced Recovery after Surgery (ERAS) accelerate recovery, reduce morbidity, and shorten hospital stay in a wide range of surgical specialties. We established a standardised multimodal ERAS pathway for patients who were being treated by free tissue transfer for head and neck cancer to evaluate its benefit. Our primary outcome was duration of hospital stay, and secondary outcomes included complications, number of days to first mobilisation, and readmission rates. We compared 100 consecutive patients who followed the ERAS programme with a control group of 40 consecutive patients who had free tissue transfer before the ERAS programme was introduced. There was a significantly reduced median duration of stay from 14days in the control group to 10days in the ERAS group. Patients in the ERAS group who were aged over 60 years, or had tracheostomies, or who required bone resection also had a significantly reduced duration of stay. There was no difference between morbidity and readmission rates, although patients in the ERAS group were mobilised significantly earlier. The ERAS programme is safe and effective for patients who are treated by free tissue transfer for head and neck cancer, and potentially reduces their duration of stay in hospital.
手术后加速康复（ERAS）计划可加快康复速度、降低发病率并缩短多种外科专科手术患者的住院时间。我们为接受头颈部癌游离组织移植治疗的患者建立了标准化的多模式ERAS路径，以评估其益处。我们的主要结局指标是住院时间，次要结局指标包括并发症、首次活动天数和再入院率。我们将连续100例遵循ERAS计划的患者与40例在ERAS计划引入之前接受游离组织移植的连续患者组成的对照组进行了比较。对照组的中位住院时间为14天，ERAS组显著缩短至10天。年龄超过60岁、行气管切开术或需要进行骨切除术的ERAS组患者住院时间也显著缩短。发病率和再入院率之间没有差异，尽管ERAS组患者的活动时间明显更早。ERAS计划对头颈部癌游离组织移植治疗的患者是安全有效的，并有可能缩短他们的住院时间。
