胃癌手术后的加速康复（ERAS-GC）：优化患者预后。
Enhanced recovery after surgery for gastric cancer (ERAS-GC): optimizing patient outcome.
作者信息
Desiderio Jacopo, Trastulli Stefano, D'Andrea Vito, Parisi Amilcare
机构信息
Department of Digestive Surgery, St. Mary's Hospital, Terni, Italy.
Department of Surgical Sciences, La Sapienza University of Rome, Rome, Italy.
出版信息
Transl Gastroenterol Hepatol. 2020 Jan 5;5:11. doi: 10.21037/tgh.2019.10.04. eCollection 2020.
Abstract
Significant advances were achieved, in last decades, in the management of surgical patients with gastric cancer. This has led to the concept of enhanced recovery after surgery (ERAS) with the objective of reducing the length of hospital stay, accelerating postoperative recovery and reducing the surgical stress. The ERAS protocols have many items, including the pre-operative patient education, early mobilization and feeding starting from the first postoperative day. This review aims to highlight possible advantages on postoperative functional recovery outcomes after gastrectomy in patients undergoing an ERAS program, current lack of evidences and future perspectives.
摘要
在过去几十年中，胃癌手术患者的管理取得了重大进展。这催生了术后加速康复（ERAS）的概念，其目标是缩短住院时间、加速术后康复并减轻手术应激。ERAS方案包含许多项目，包括术前患者教育、早期活动以及术后第一天开始进食。本综述旨在强调接受ERAS方案的患者在胃切除术后功能恢复结果方面可能存在的优势、当前证据的不足以及未来展望。
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3
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