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在加速康复外科理念下机械性肠道准备对老年泌尿外科肿瘤机器人手术后电解质紊乱和功能恢复的前瞻性研究。

Prospective study on the effects of mechanical bowel preparation under the enhanced recovery after surgery concept on electrolyte disturbances and functional recovery after robotic surgery for urologic tumors in older adults.

机构信息

Department of Urology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150086, China.

出版信息

BMC Urol. 2024 Aug 28;24(1):184. doi: 10.1186/s12894-024-01577-7.

DOI:10.1186/s12894-024-01577-7
PMID:39198778
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11351007/
Abstract

BACKGROUND

Mechanical bowel preparation (MBP) involves the cleansing of bowel excreta and secretions using methods such as preoperative oral laxatives, retrograde enemas, and dietary adjustments. When combined with oral antibiotics, preoperative MBP can effectively lower the risk of anastomotic leakage, minimize the occurrence of postoperative infections, and reduce the likelihood of other complications. To study the effects of MBP under the Enhanced Recovery After Surgery (ERAS) concept on postoperative electrolyte disorders and functional recovery in older people with urological tumors undergoing robot-assisted surgery.

METHODS

Older people with urological tumors undergoing robot-assisted surgery were randomly divided into two groups. The experimental group (n = 76) underwent preoperative MBP, while the control group (n = 72) did not. The differences in electrolyte levels and functional recovery between the two groups after radical surgery for urological tumors were observed.

RESULTS

The incidence of postoperative electrolyte disorders was significantly higher in the experimental group compared to the control group, with incidence rates of 42.1% and 19.4%, respectively (P < 0.05). Subgroup analysis showed that the electrolyte disorder was age-related (P < 0.05). There were no significant differences between the two groups in terms of postoperative complications, gastrointestinal function recovery, laboratory indicators of infection, body temperature, and length of hospital stay (P > 0.05).

CONCLUSION

Under the accelerated recovery background, preoperative MBP increases the risk of postoperative electrolyte disorders in older people with urological tumors and does not reduce the incidence of postoperative complications or promote postoperative functional recovery.

摘要

背景

机械肠道准备(MBP)涉及使用术前口服轻泻剂、逆行灌肠和饮食调整等方法清洁肠道排泄物和分泌物。当与口服抗生素结合使用时,术前 MBP 可以有效降低吻合口漏的风险,最大限度地减少术后感染的发生,并降低其他并发症的可能性。为了研究在加速康复(ERAS)概念下 MBP 对接受机器人辅助手术的老年泌尿外科肿瘤患者术后电解质紊乱和功能恢复的影响。

方法

将接受机器人辅助手术的老年泌尿外科肿瘤患者随机分为两组。实验组(n=76)接受术前 MBP,对照组(n=72)则不接受。观察两组根治性手术治疗泌尿外科肿瘤后电解质水平和功能恢复的差异。

结果

实验组术后电解质紊乱的发生率明显高于对照组,分别为 42.1%和 19.4%(P<0.05)。亚组分析显示,电解质紊乱与年龄有关(P<0.05)。两组在术后并发症、胃肠功能恢复、感染的实验室指标、体温和住院时间方面无显著差异(P>0.05)。

结论

在加速康复背景下,术前 MBP 增加了老年泌尿外科肿瘤患者术后电解质紊乱的风险,并且不能降低术后并发症的发生率或促进术后功能恢复。

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