Digestive Surgery, European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.
Updates Surg. 2023 Jan;75(1):141-148. doi: 10.1007/s13304-022-01400-8. Epub 2022 Oct 28.
Enhanced recovery after surgery (ERAS) programs have been developed by combining several evidence-based techniques for perioperative care, with the intention of reducing the stress response and organ dysfunction, thus allowing improved clinical results. ERAS programs have been widely adopted for colorectal surgery; however, their adoption for upper gastrointestinal surgery has been challenging even though good results have been reported in the literature. Our intent was to investigate the adoption of ERAS programs for resective gastric surgery in Italy. A survey was conducted among 20 departments of surgery belonging to the Italian Group for Research on Gastric Cancer (GC). Analysis of our survey showed that several evidence-based practices and many items of the ERAS guidelines for gastric surgery are not implemented in real practice in Italian centers dedicated to GC. This situation may be related to the hesitation of surgeons to introduce radical changes to the traditional postoperative management after gastrectomy. A multidisciplinary approach to the perioperative care of these patients is not routinely applied in many Italian centers. A strict collaboration of all clinicians involved in the perioperative care of patients undergoing gastrectomy for GC is key for the future implementation of ERAS in gastric surgery in our departments.
术后恢复加速（ERAS）方案通过结合围手术期护理的几种循证技术而制定，其目的是减轻应激反应和器官功能障碍，从而改善临床结果。ERAS 方案已广泛应用于结直肠手术，但即使文献中报告了良好的结果，其在上消化道手术中的应用仍具有挑战性。我们旨在调查意大利胃切除术的 ERAS 方案的采用情况。我们对属于意大利胃癌研究组（GC）的 20 个外科部门进行了一项调查。我们的调查分析表明，在专注于 GC 的意大利中心，胃切除术的循证实践和 ERAS 指南的许多项目并未实际实施。这种情况可能与外科医生在胃癌手术后传统的术后管理方面犹豫不决有关。对这些患者进行围手术期的多学科管理在许多意大利中心并未常规应用。在我们的科室中，严格协作所有参与 GC 患者围手术期护理的临床医生是 ERAS 在胃外科中未来实施的关键。
