中国基于社区医院加入加速康复外科（CHJ-ERAS）项目的日间腹腔镜回肠造口还纳术：安全可行。
Day-case loop ileostomy reversal based on the community hospital joined enhanced recovery after surgery (CHJ-ERAS) program in China: Safe and feasible.
机构信息
Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China.
Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China.
出版信息
Am J Surg. 2023 Jul;226(1):70-76. doi: 10.1016/j.amjsurg.2023.01.027. Epub 2023 Feb 1.
BACKGROUND
This study was performed to determine the feasibility of Day-case loop ileostomy reversal (DLIR) in China based on the community hospital joined enhanced recovery after surgery (CHJ-ERAS) program.
METHOD
Patients who underwent loop ileostomy were enrolled in the CHJ-ERAS program for DLIR after rigorous evaluation. The primary outcome was the results of short-term follow-ups.
RESULTS
From August 2017 to April 2022, 216 patients have been enrolled in the CHJ-ERAS program for DLIR. After DLIR, 14 patients (14/216, 6.5%) have recorded 17 episodes of postoperative complications within 1 month after surgery, including 10 readmission and 2 reoperation. Compared with in-patient loop ileostomy reversal, DLIR based on CHJ-ERAS did not increase the postoperative complications and reoperations.
CONCLUSION
The CMJ-ERAS program for DLIR in our center is a safe and feasible alternative option for inpatient LIR and an acceptable transitional approach for the development of day-case DLIR in developing countries.
背景
本研究旨在基于社区医院加入加速康复外科（CHJ-ERAS）项目，确定中国开展日间腹腔镜回肠造口还纳术（DLIR）的可行性。
方法
对严格评估后符合条件的行回肠袢式造口术的患者纳入 CHJ-ERAS 项目行 DLIR。主要观察指标为短期随访结果。
结果
2017 年 8 月至 2022 年 4 月，216 例患者纳入 CHJ-ERAS 项目行 DLIR。DLIR 后，术后 1 个月内 14 例（14/216，6.5%）患者发生 17 例术后并发症，包括 10 例再入院和 2 例再次手术。与住院行回肠造口还纳术相比，CHJ-ERAS 指导下的 DLIR 并未增加术后并发症和再次手术率。
结论
本中心的 CHJ-ERAS 项目指导下的 DLIR 是一种安全且可行的住院 LIR 替代方案，也是发展中国家开展日间 DLIR 的可接受的过渡方法。
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