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手术后加速康复(ERAS)方案:一次医疗综合体验。

Enhanced Recovery After Surgery (ERAS) Approach: A Medical Complex Experience.

作者信息

Elsenosy Abdelfatah M, Hassan Eslam, Abdelgader Mujtaba, Elgamily Omar S, Hegazy Abdelhares

机构信息

Trauma and Orthopaedics, University Hospitals Dorset, Poole, GBR.

Trauma and Orthopaedics, Poole General Hospital, Poole, GBR.

出版信息

Cureus. 2023 Dec 28;15(12):e51208. doi: 10.7759/cureus.51208. eCollection 2023 Dec.

Abstract

BACKGROUND

Enhanced recovery after surgery (ERAS) is a multimodal, multidisciplinary approach aimed at reducing organ failure and mitigating stress reactions in surgery patients. This investigation sought to assess available data concerning the benefits of ERAS protocols in improving patient outcomes for individuals undergoing significant colorectal surgery.

METHODS

The study involved 65 patients who underwent colectomy and lower anterior resection for rectal cancers. Patients were divided into three groups: Group 1 comprised 22 patients enrolled retrospectively who received the traditional protocol; Group 2 consisted of 20 patients enrolled prospectively who received the ERAS protocol; and Group 3 included 23 patients enrolled retrospectively who received the ERAS protocol. Each patient underwent a comprehensive history, physical examination, laboratory testing, computed tomography, MRI, and chest radiography.

RESULTS

Hospital stay durations were significantly shorter in both ERAS groups during the first and second cycles compared to the non-ERAS group (P<0.001, <0.001), with no significant difference between ERAS groups in either cycle. Delayed intestinal motility was significantly more pronounced in the non-ERAS group compared to ERAS groups in both cycles (P=0.005), with only five (22.7%) cases reported in the non-ERAS group.

CONCLUSION

ERAS implementation in the perioperative management of colorectal surgery patients is associated with improved outcomes and shorter recovery times. Implementation of ERAS in hospitals is feasible and beneficial.

摘要

背景

术后加速康复(ERAS)是一种多模式、多学科的方法,旨在减少手术患者的器官功能衰竭并减轻应激反应。本研究旨在评估关于ERAS方案对接受重大结直肠手术患者改善预后益处的现有数据。

方法

该研究纳入了65例行结肠癌切除术和直肠癌低位前切除术的患者。患者分为三组:第1组包括22例回顾性纳入的接受传统方案的患者;第2组由20例前瞻性纳入的接受ERAS方案的患者组成;第3组包括23例回顾性纳入的接受ERAS方案的患者。每位患者均接受了全面的病史采集、体格检查、实验室检查、计算机断层扫描、磁共振成像和胸部X线检查。

结果

与非ERAS组相比,两个ERAS组在第一个和第二个周期的住院时间均显著缩短(P<0.001,<0.001),两个ERAS组在任一周期均无显著差异。在两个周期中,非ERAS组的肠道蠕动延迟均比ERAS组明显更显著(P=0.005),非ERAS组仅报告了5例(22.7%)。

结论

在结直肠手术患者的围手术期管理中实施ERAS与改善预后和缩短恢复时间相关。在医院实施ERAS是可行且有益的。

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