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腹腔镜手术与 ERAS 路径相结合可优化肾上腺切除术的疗效和成本。

A combination of laparoscopic approach and ERAS pathway optimizes outcomes and cost for adrenalectomy.

机构信息

Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China.

Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China.

出版信息

Updates Surg. 2022 Apr;74(2):519-525. doi: 10.1007/s13304-021-01188-z. Epub 2021 Oct 11.

Abstract

Enhanced recovery after surgery (ERAS) pathway comprises a set of comprehensive elements which have been reported to enhance patient postoperative prognosis. In the current study, we aimed to evaluate the effectiveness of the ERAS in patients undergoing laparoscopic adrenal resection. A retrospective review was performed to compare the outcomes of patients undergoing adrenalectomy for primary aldosteronism between the pre-ERAS period and the ERAS era. Data was generated from the traditional surgical period (September 1, 2019, to December 31, 2019) and the ERAS period (September 1, 2020, to December 31, 2020), respectively. Forty-seven adrenalectomy patients were enrolled (pre-ERAS, n = 21; ERAS, n = 26) in analysis. The results revealed that both total length of hospital stay and postoperative length of stay decreased in the ERAS period compared with the pre-ERAS period (14.19 ± 4.96 vs 11.27 ± 4.37, p = 0.015; 5.43 ± 1.08 vs 3.31 ± 0.97, p < 0.001). The medical expenses decreased significantly in the ERAS group (p < 0.05). While, the surgery-related complications, including urinary retention, retroperitoneal effusion and gastrointestinal discomfort, possessed no statistical difference. The ERAS pathway was safe and feasible for adrenalectomy in patients with primary aldosteronism. The ERAS could promote patients to quickly recover from the postoperative status to a physiological state, and decrease the length of hospitalization and medical cost after surgery.

摘要

术后加速康复(ERAS)路径包括一组已被报道可改善患者术后预后的综合要素。在本研究中,我们旨在评估 ERAS 在腹腔镜肾上腺切除术患者中的有效性。我们进行了一项回顾性研究,比较了原发性醛固酮增多症患者在 ERAS 前和 ERAS 时代接受肾上腺切除术的结果。数据分别来自传统手术时期(2019 年 9 月 1 日至 12 月 31 日)和 ERAS 时期(2020 年 9 月 1 日至 12 月 31 日)。共有 47 例肾上腺切除术患者被纳入分析(ERAS 前组,n=21;ERAS 组,n=26)。结果显示,与 ERAS 前组相比,ERAS 组的总住院时间和术后住院时间均缩短(14.19±4.96 vs 11.27±4.37,p=0.015;5.43±1.08 vs 3.31±0.97,p<0.001)。ERAS 组的医疗费用显著降低(p<0.05)。然而,手术相关并发症,包括尿潴留、腹膜后积液和胃肠道不适,两组间无统计学差异。ERAS 路径对于原发性醛固酮增多症患者的肾上腺切除术是安全可行的。ERAS 可以促进患者从术后状态快速恢复到生理状态,并减少术后住院时间和医疗费用。

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