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胰腺手术后加速康复:一项前瞻性随机对照临床试验。

Enhanced recovery after pancreatic surgery: A prospective randomized controlled clinical trial.

机构信息

Department of General Surgery, School of Medicine, Marmara University, Istanbul, Turkey.

Department of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey.

出版信息

J Surg Oncol. 2021 Dec;124(7):1070-1076. doi: 10.1002/jso.26614. Epub 2021 Jul 20.

Abstract

BACKGROUND AND OBJECTIVES

The enhanced recovery after surgery (ERAS) protocol is a perioperative care bundle designed to achieve early healing after surgical procedures. This study aims to investigate the effect of the ERAS protocol on postoperative complications, length of hospital stay (LOS), and readmission rates in pancreatic surgery patients.

METHODS

The study was designed as a prospective and randomized controlled study between January 2016 and November 2018 on pancreatic surgery patients. A total of 38 patients were analyzed, 18 of whom were in the ERAS group and 20 in the control group. Patient demographics, intraoperative variables, and postoperative outcomes were recorded.

RESULTS

The groups were similar regarding age, sex, surgery type, American Society of Anesthesiologists scores, and laboratory results. There was no significant difference in the intraoperative variables. Early oral feeding was preferred, mostly in the ERAS group compared to the control group. Perioperative complication rates, including delayed gastric emptying and pancreatic fistula, LOS, and readmission rates, were similar between the two groups.

CONCLUSIONS

The ERAS protocol provided a minimal decrease in the total complication rates and had no effect on severe complications. Therefore, the ERAS protocol seems feasible and can be applied safely in pancreatic surgery patients.

摘要

背景与目的

加速康复外科(ERAS)方案是一种围手术期护理措施,旨在促进手术后的早期康复。本研究旨在探讨 ERAS 方案对胰腺手术患者术后并发症、住院时间(LOS)和再入院率的影响。

方法

本研究为 2016 年 1 月至 2018 年 11 月期间胰腺手术患者的前瞻性随机对照研究。共分析了 38 例患者,其中 18 例为 ERAS 组,20 例为对照组。记录患者的人口统计学、术中变量和术后结果。

结果

两组患者的年龄、性别、手术类型、美国麻醉医师协会评分和实验室结果相似。术中变量无显著差异。早期口服喂养更受欢迎,ERAS 组明显多于对照组。两组患者的围手术期并发症发生率(包括胃排空延迟和胰瘘)、LOS 和再入院率相似。

结论

ERAS 方案可降低总并发症发生率,但对严重并发症无影响。因此,ERAS 方案在胰腺手术患者中是可行且安全的。

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