Department of Head and Neck Surgery, Miyagi Cancer Center, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi 981-1293, Japan.
Department of Head and Neck Surgery, Miyagi Cancer Center, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi 981-1293, Japan.
Auris Nasus Larynx. 2024 Feb;51(1):38-50. doi: 10.1016/j.anl.2023.08.001. Epub 2023 Aug 7.
The enhanced recovery after surgery (ERAS) pathway is designed to facilitate recovery after surgery by packaging evidence-based protocols specific to each aspect of the perioperative period, including the preoperative, intraoperative, postoperative, and post-discharge periods. The ERAS pathway, which was originally developed for use with colonic resection, is now being expanded to include a variety of surgical procedures, and the ERAS Society has published a consensus review of the ERAS pathway for head and neck surgery with free tissue transfer reconstruction (HNS-FTTR). The ERAS pathway for HNS-FTTR consists of various important protocols, including early postoperative mobilization, early postoperative enteral nutrition, abolition of preoperative fasting, preoperative enteral fluid loading, multimodal pain management, and prevention of postoperative nausea and vomiting. In recent years, meta-analyses investigating the utility of the ERAS pathway in head and neck cancer surgery have also been presented, and all reports showed that the length of the postoperative hospital stay was reduced by the implementation of the ERAS pathway. The ERAS pathway is now gaining traction in the field of head and neck surgery; however, the details of its efficacy remain uncertain. We believe the future direction will require research focused on improving the quality of postoperative patient recovery and patient satisfaction. It will be important to use patient-reported outcomes to determine whether the ERAS pathway is actually beneficial.
术后加速康复（ERAS）路径旨在通过包装围手术期各个方面的循证方案来促进手术后的康复，包括术前、术中、术后和出院后。最初为结肠切除术开发的 ERAS 路径现在正在扩展到包括各种手术程序，并且 ERAS 协会已经发布了关于头颈部手术伴游离组织转移重建（HNS-FTTR）的 ERAS 路径的共识审查。HNS-FTTR 的 ERAS 路径包括各种重要的方案，包括术后早期活动、术后早期肠内营养、取消术前禁食、术前肠内液负荷、多模式疼痛管理和预防术后恶心和呕吐。近年来，还提出了关于 ERAS 路径在头颈部癌症手术中应用的荟萃分析，所有报告均表明，实施 ERAS 路径可缩短术后住院时间。ERAS 路径现在在头颈部手术领域受到关注；然而，其疗效的细节仍不确定。我们相信未来的方向将需要研究集中在改善术后患者康复质量和患者满意度上。使用患者报告的结果来确定 ERAS 路径是否实际上有益将很重要。
