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微创食管手术的强化康复路径

Enhanced Recovery Pathways for Minimally Invasive Esophageal Surgery.

作者信息

Yost Mark T, Jolissaint Joshua S, Fields Adam C, Fisichella P Marco

机构信息

1 Harvard Medical School , Boston, Massachusetts.

2 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.

出版信息

J Laparoendosc Adv Surg Tech A. 2018 May;28(5):496-500. doi: 10.1089/lap.2018.0073. Epub 2018 Mar 22.

Abstract

INTRODUCTION

The outcomes for enhanced recovery after surgery (ERAS) have yet to be thoroughly studied in minimally invasive esophageal surgery. In this review, we examine the literature to provide an overview of the current state of ERAS in minimally invasive esophageal surgery.

METHODS

We searched the PubMed database up to January 2018 for relevant literature. We reviewed two randomized controlled trials, one Cochrane Review, two meta-analyses, three systematic reviews, three prospective cohort studies, three retrospective case-control studies, one consecutive series, and several other studies pertaining to ERAS in minimally invasive esophageal surgery.

RESULTS

Compared with conventional perioperative care, ERAS pathways after minimally invasive esophageal procedures reduce postoperative hospital length of stay, encourage earlier return of bowel function, increase cost savings, and do not significantly change perioperative complication rates.

CONCLUSIONS

We recommend that patients undergoing minimally invasive esophageal surgery enter a postoperative ERAS pathway to maximize recovery. ERAS pathways offer the best opportunity for successful postoperative recovery without negatively impacting patient safety.

摘要

引言

手术加速康复(ERAS)在微创食管手术中的效果尚未得到充分研究。在本综述中,我们查阅文献以概述微创食管手术中ERAS的现状。

方法

我们检索了截至2018年1月的PubMed数据库中的相关文献。我们回顾了两项随机对照试验、一篇Cochrane系统评价、两项荟萃分析、三项系统评价、三项前瞻性队列研究、三项回顾性病例对照研究、一项连续系列研究以及其他一些与微创食管手术中ERAS相关的研究。

结果

与传统围手术期护理相比,微创食管手术后的ERAS方案可缩短术后住院时间,促进肠道功能更早恢复,节省费用,且不会显著改变围手术期并发症发生率。

结论

我们建议接受微创食管手术的患者采用术后ERAS方案以实现最大程度的康复。ERAS方案为术后成功康复提供了最佳机会,且不会对患者安全产生负面影响。

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