Che Guowei
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhongguo Fei Ai Za Zhi. 2018 Mar 20;21(3):168-172. doi: 10.3779/j.issn.1009-3419.2018.03.08.
The development of surgical techniques and the innovation of surgical instruments promote the changes in surgical methods, which in turn, leads to the reforms of surgical idea. The concept of enhanced recovery after surgery (ERAS) results in the surgery connotation switching from "to treat an illness" to "to save patients". ERAS also causes the change of surgery denotation from "only operation" to "enhance recovery". The concept of ERAS is derived from but not only restricted to the development of surgical techniques. Also, ERAS pays more attention to patients than disease and thinks more about patient safety and recovery than surgical technique. Specifically, ERAS has three advantages: first, ERAS attaches importance to multidisciplinary assessment (patient-oriented) and select appropriate (personalized) treatment and tries to decrease the rate of complication and mortality. Second, ERAS pays attention to preoperative preparation and high-risk prevention performed by multi-disciplinary collaboration in order to prevent complication and save cost for patients. Third, ERAS always focus on optimizing the process of perioperative period and trying to change the working habits of surgeons and the old cooperation mode among doctors, nurses and rehabilitation physicians. To sum up, the goal is to apply the concept of ERAS to all the links of perioperative period and try hard to decrease patients' stress and pain, which finally helps doctors fulfill the ultimate aims of "no pain and no risk". .
外科技术的发展和手术器械的创新推动了手术方式的变革,进而引发了手术理念的革新。加速康复外科(ERAS)理念使手术内涵从“治病”向“救人”转变,手术外延也从“单纯手术”向“促进康复”转变。ERAS理念源于但不限于外科技术的发展,它更关注患者而非疾病,更多地考虑患者安全和康复而非手术技术。具体而言,ERAS有三个优点:其一,ERAS重视多学科评估(以患者为导向),选择合适的(个性化)治疗方式,努力降低并发症发生率和死亡率。其二,ERAS注重术前准备和多学科协作进行的高危预防,以预防并发症并为患者节省费用。其三,ERAS始终致力于优化围手术期流程,试图改变外科医生的工作习惯以及医生、护士和康复医师之间旧有的合作模式。总之,目标是将ERAS理念应用于围手术期的所有环节,努力减轻患者的应激和疼痛,最终帮助医生实现“无痛无险”的终极目标。