Shirakawa Yasuhiro
Nihon Geka Gakkai Zasshi. 2017 Mar;118(2):149-54.
In the past, most duties in perioperative management were carried out directly by surgeons themselves. However, in that conventional approach, the experience and knowledge of the responsible surgeon made a difference to the postoperative course. As hospital stays have become shorter in recent years, the preoperative hospitalization period is now only one to two days. It has become more difficult to prepare patients sufficiently, both physically and mentally, so that they undergo surgery with peace of mind. To overcome this situation, the Perioperative Management Center (PERIO) was opened at Okayama University Hospital in 2008, and patients undergoing esophageal cancer surgery have been accepted since 2009. In PERIO, multidisciplinary medical staff share information on patients throughout the organization, and team medical intervention is performed from the preoperative outpatient period. The introduction of PERIO has resulted in earlier postoperative resumption of mobility and shorter postoperative stays. Furthermore, according to a patient survey, PERIO provides an environment that enables patients to face surgery calmly. As the next stage, intraoperative and postoperative interventions in PERIO should be enhanced for a safer perioperative environment and even greater peace of mind for patients.
过去,围手术期管理的大部分工作直接由外科医生自己完成。然而,在那种传统方法中,负责的外科医生的经验和知识对术后病程有影响。近年来,由于住院时间缩短,目前术前住院期仅为一到两天。要让患者在身心两方面都做好充分准备,从而安心接受手术变得更加困难。为克服这种情况,2008年冈山大学医院开设了围手术期管理中心(PERIO),自2009年起接收接受食管癌手术的患者。在PERIO,多学科医护人员在整个机构内共享患者信息,并从术前门诊阶段就进行团队医疗干预。PERIO的引入使患者术后能更早恢复活动能力,术后住院时间也更短。此外,根据患者调查,PERIO提供了一个能让患者从容面对手术的环境。作为下一阶段,应加强PERIO的术中及术后干预,以营造更安全的围手术期环境,让患者更加安心。