Cleveland Clinic Center for Abdominal Core Health, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Hernia. 2024 Nov 15;29(1):4. doi: 10.1007/s10029-024-03203-9.
Enhanced recovery after surgery (ERAS) protocols are widely used in the post-operative care of hernia patients. Despite their prevalence, an absence of published consensus guidelines creates significant heterogeneity in practices. The aim of this study was to evaluate elements in ERAS protocols utilized in ventral hernia repair from institutions across the United States and provide consensus recommendations for each identified element.
Institutional members of the Abdominal Core Health Quality Collaborative (ACHQC) Quality Improvement (QI) committee submitted current ERAS protocols. Items within each protocol were classified as "elements", then assigned a topic. Any topic with ≥ 2 elements from separate institutions were labeled as a "theme," then grouped by stage in the patient care cycle. A brief review of current evidence was provided in addition to a ACHQC QI committee consensus statement.
A total of 295 elements from 6 tertiary referral centers specializing in hernia care were compiled into 24 themes and grouped by four separate stages: Pre-Admission Optimization, Pre-Operative Care, Intra-operative Care, and Post-Operative Management.
This article represents a multi-institutional review of ERAS protocols for ventral hernia repair and identifies common themes that may provide the framework for a unified ERAS protocol in hernia surgery. Future work may serve to develop societal guidelines defined specifically for enhanced recovery in ventral hernia repair.
术后恢复加速（ERAS）方案广泛应用于疝患者的术后护理。尽管它们很普遍，但缺乏已发表的共识指南导致实践中存在很大的异质性。本研究旨在评估美国各机构在腹疝修补术中使用的 ERAS 方案中的要素，并为每个确定的要素提供共识建议。
腹核心健康质量协作（ACHQC）质量改进（QI）委员会的机构成员提交了当前的 ERAS 方案。每个方案中的项目被归类为“要素”，然后分配一个主题。任何有来自不同机构的≥2 个要素的主题都被标记为“主题”，然后按照患者护理周期的阶段进行分组。除了提供 ACHQC QI 委员会的共识声明外，还对当前的证据进行了简要回顾。
共从 6 家专门从事疝治疗的三级转诊中心收集了 295 个要素，分为 24 个主题，并分为四个独立阶段：入院前优化、术前护理、术中护理和术后管理。
本文代表了对腹疝修补术 ERAS 方案的多机构审查，并确定了可能为疝手术的统一 ERAS 方案提供框架的常见主题。未来的工作可能旨在制定专门针对腹疝修复中加速康复的社会指南。
