People's Hospital of Changwu County, Xianyang, China.
J Laparoendosc Adv Surg Tech A. 2023 Sep;33(9):884-889. doi: 10.1089/lap.2023.0168. Epub 2023 Jun 1.
Enhanced recovery after surgery (ERAS) protocol is an effective evidence-based multidisciplinary protocol to optimize the postsurgical recovery process through perioperative interventions. The aim of the present study was to evaluate the effects of ERAS program on operation-related indicators, complications, pain, and quality of life in patients older than 60 years undergoing the transabdominal preperitoneal (TAPP) approach. This was a retrospective study of prospectively collected data from a single institution. A total of 160 elderly patients who underwent TAPP were divided into two groups: 80 patients in the ERAS group from January 2019 to December 2020, and 80 patients in the non-ERAS group from January 2021 to December 2022 in the non-ERAS group, and the groups were managed with the ERAS protocol and conventional management, respectively. We compared differences in operation-related indicators, complications, pain, and quality of life between the two groups. Operation-related indicators (exhaust time, postoperative eating time, time to first ambulation, hospitalization cost, and postoperative hospital stay) and early postoperative pain of the ERAS group were superior to those of the non-ERAS group, and the difference had statistical significance ( < .05). More importantly, our results demonstrated that compared with the non-ERAS group, the application of ERAS in inguinal hernia patients may reduce postoperative complications (urinary retention, chronic pain) and improve quality of life. The ERAS program might provide the efficiency and safety approach to optimize clinical outcomes in the elderly patients older than 60 years undergoing TAPP approach.
术后加速康复(ERAS)方案是一种有效的循证多学科方案,通过围手术期干预来优化术后恢复过程。本研究旨在评估 ERAS 方案对行经腹腹膜前(TAPP)入路的 60 岁以上患者的手术相关指标、并发症、疼痛和生活质量的影响。这是一项对单中心前瞻性收集数据的回顾性研究。共有 160 例行 TAPP 的老年患者被分为两组:2019 年 1 月至 2020 年 12 月的 80 例 ERAS 组和 2021 年 1 月至 2022 年 12 月的 80 例非 ERAS 组,两组分别采用 ERAS 方案和常规管理。我们比较了两组之间手术相关指标、并发症、疼痛和生活质量的差异。ERAS 组的手术相关指标(排气时间、术后进食时间、首次下床活动时间、住院费用和术后住院时间)和早期术后疼痛优于非 ERAS 组,差异具有统计学意义( < .05)。更重要的是,我们的结果表明,与非 ERAS 组相比,ERAS 在腹股沟疝患者中的应用可能会降低术后并发症(尿潴留、慢性疼痛)并提高生活质量。ERAS 方案可能为行 TAPP 入路的 60 岁以上老年患者提供优化临床结局的有效且安全的方法。