Yin Tzu-Chieh, Huang Ching-Wen, Tsai Hsiang-Lin, Su Wei-Chih, Ma Cheng-Jen, Chang Tsung-Kun, Wang Jaw-Yuan
Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Surgery, Kaohsiung Municipal Tatung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Front Surg. 2021 Jan 20;7:608950. doi: 10.3389/fsurg.2020.608950. eCollection 2020.
Enhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies. Patients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative days 1 and 3, and on the day of discharge. Smartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The length of hospital stay, as defined by discharge criteria, and hospital stay of patients without complications was reduced by 1.1 and 0.9 days, respectively ( = 0.009 and 0.049, respectively). Smartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.
术后加速康复（ERAS）在围手术期护理中具有重要价值，因为它能够改善短期手术效果，并促进大手术后患者的康复。术后早期活动是综合护理路径的重要组成部分，也是与成功预后密切相关的一个因素。然而，早期活动仍有各种定义，且缺乏具体策略。接受结直肠癌微创手术的患者遵循我们的围手术期ERAS方案，包括术后第一天开始活动。在我们成熟的方案中提高围手术期护理技能后，评估了使用智能手环的依从性、住院手术效果以及相关并发症，并与标准方案的结果进行比较。在手术前一天、术后第1天和第3天以及出院当天，使用患者自评的QoR-40问卷评估康复质量。与标准ERAS方案相比，微创结直肠癌手术后使用智能手环未能显著提高早期活动的依从性或降低术后并发症的发生率。然而，当使用智能手环时，康复质量得到优化，患者在术后第3天更早恢复到术前状态。根据出院标准确定的住院时间以及无并发症患者的住院时间分别缩短了1.1天和0.9天（分别为=0.009和0.049）。智能手环能够加强患者与手术团队之间的沟通，并增强接受微创结直肠切除术患者的自我管理能力。在ERAS期间，将智能手环整合到早期活动过程中可以促进患者加速恢复到术前功能状态。
