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八九十岁老人胃切除术后快速康复:单中心回顾性分析。

ERAS following Gastrectomy for Octo- and Nonagenarians: A Single-Center Retrospective Analysis.

机构信息

Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Center, Montreal, Quebec, Canada.

出版信息

J Laparoendosc Adv Surg Tech A. 2024 Jun;34(6):484-489. doi: 10.1089/lap.2024.0058. Epub 2024 May 21.

Abstract

The safety and efficacy of enhanced recovery after surgery (ERAS) following elective gastrectomy for gastric cancer in patients >80 years of age are not well described. The aim of this study was to explore whether an ERAS protocol following gastrectomy in this age group can be safely implemented and reduce postoperative length of stay. A retrospective, single-center analysis was performed. All patients >80 years of age with gastric cancer undergoing elective subtotal and total gastrectomy between January 2010 and December 2021 were identified. With the implementation of an ERAS protocol in January 2016, patients treated beforehand were allocated to Group A (pre-ERAS) and Group B (ERAS). The length of stay, incidence of postoperative complications and representation/readmission to the hospital were compared between the groups. Of the 221 patients identified, 56 met the inclusion criteria with 22 patients (39.3%) allocated to Group A and 34 patients (60.7%) to Group B. There were no differences with regard to the type of resection and surgical approach. Length of stay was shorter in Group B (5 days, range 2-27 versus 10 days, 3-109, = .040). A trend toward more discharges by postoperative day 3 was noted among patients in Group B (7/34, 20.6% versus 2/22, 9.1%, = .253). There were no differences in the incidence of postoperative complications or readmission hospital between the groups. Among patients >80 years of age, ERAS following gastrectomy for cancer is associated with a reduced length of stay and can be safely implemented.

摘要

对于 80 岁以上的患者行择期胃癌胃切除术(ERAS)后,其安全性和疗效尚未得到很好的描述。本研究旨在探讨该年龄组患者接受胃切除术后实施 ERAS 方案是否安全,能否减少术后住院时间。这是一项回顾性、单中心分析。2010 年 1 月至 2021 年 12 月期间,所有 80 岁以上行择期胃大部或全胃切除术的胃癌患者均被纳入研究。2016 年 1 月实施 ERAS 方案后,将之前治疗的患者分为 A 组(ERAS 前)和 B 组(ERAS)。比较两组患者的住院时间、术后并发症发生率和再次入院情况。共纳入 221 例患者,其中 56 例符合纳入标准,22 例(39.3%)分配至 A 组,34 例(60.7%)分配至 B 组。两组患者的手术类型和手术方式无差异。B 组患者的住院时间更短(5 天,范围 2-27 天与 10 天,3-109 天, =.040)。B 组患者术后第 3 天出院的比例更高(7/34,20.6%与 2/22,9.1%, =.253)。两组患者的术后并发症发生率和再次入院率无差异。对于 80 岁以上的患者,胃癌胃切除术后实施 ERAS 与住院时间缩短相关,且安全可行。

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