Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Huichuan District, Zunyi, 563099, Guizhou Province, China.
Department of Gastrointestinal Surgery, Guizhou Provincial People's Hospital, No. 83, Zhongshan East Road, Nanming District, Guiyang, 550499, Guizhou, China.
Sci Rep. 2024 Sep 15;14(1):21539. doi: 10.1038/s41598-024-72835-9.
Da Vinci robot-assisted pancreaticoduodenectomy offers advantages, including minimal invasiveness, precise, and safe procedures. This study aimed to investigate the clinical effectiveness of implementing enhanced recovery after surgery (ERAS) concepts in Da Vinci robot-assisted pancreaticoduodenectomy. A retrospective analysis was conducted on clinical data from 62 patients who underwent Da Vinci robot-assisted pancreaticoduodenectomy between January 2018 and December 2022. Among these patients, 30 were managed with ERAS principles, while 32 were managed using traditional perioperative management protocols. Surgical time, intraoperative blood loss, postoperative oral intake time, time to return of bowel function, time to ambulation, visual analog scale (VAS) pain scores, fluid replacement volume, length of hospital stay, total hospital expenses, complications, and patient satisfaction were recorded and compared between the two groups. Postoperative follow-up included assessment of postoperative functional scores, reoperation rates, SF-36 quality of life scores, and survival rates. The average follow-up time was 35.6 months (range: 12-56 months). There were no statistically significant differences in general characteristics, including age, surgical time, intraoperative blood loss, and preoperative medical history between the two groups (P > 0.05). Compared to the control group, the intervention group had an earlier postoperative oral intake time, faster return of bowel function, rapid ambulation, and shorter hospital stays (P < 0.05). The intervention group also had lower postoperative VAS scores, lower fluid replacement volume, lower total hospital expenses, and a lower rate of complications (P < 0.05). Patient satisfaction was higher in the intervention group (P < 0.05). There were no statistically significant differences between the two groups in two-year functional scores, reoperation rates, quality of life scores, and survival rates (P > 0.05). Implementing ERAS principles in Da Vinci robot-assisted pancreaticoduodenectomy substantially expedited postoperative recovery, lowered pain scores, and diminished complications. However, there were no notable differences in long-term outcomes between the two groups.
达芬奇机器人辅助胰十二指肠切除术具有微创、精确和安全的优点。本研究旨在探讨达芬奇机器人辅助胰十二指肠切除术中实施加速康复外科（ERAS）理念的临床效果。回顾性分析了 2018 年 1 月至 2022 年 12 月期间 62 例接受达芬奇机器人辅助胰十二指肠切除术的患者的临床资料。其中 30 例患者采用 ERAS 原则管理，32 例患者采用传统围手术期管理方案。记录并比较两组患者的手术时间、术中出血量、术后口服摄入时间、肠功能恢复时间、下床活动时间、视觉模拟评分（VAS）疼痛评分、液体置换量、住院时间、总住院费用、并发症和患者满意度。术后随访包括评估术后功能评分、再次手术率、SF-36 生活质量评分和生存率。平均随访时间为 35.6 个月（范围：12-56 个月）。两组患者的一般特征，包括年龄、手术时间、术中出血量和术前病史，差异均无统计学意义（P>0.05）。与对照组相比，干预组术后口服摄入时间更早，肠功能恢复更快，下床活动更快，住院时间更短（P<0.05）。干预组术后 VAS 评分较低，液体置换量较低，总住院费用较低，并发症发生率较低（P<0.05）。干预组患者满意度较高（P<0.05）。两组患者的两年功能评分、再次手术率、生活质量评分和生存率差异均无统计学意义（P>0.05）。在达芬奇机器人辅助胰十二指肠切除术中实施 ERAS 原则可显著加快术后恢复，降低疼痛评分，减少并发症。然而，两组患者的长期预后无显著差异。
