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手术室之外:结直肠手术强化康复策略的叙述性综述

Beyond the Operating Room: A Narrative Review of Enhanced Recovery Strategies in Colorectal Surgery.

作者信息

Albalawi Hamed Ibrahim Hamed, Alyoubi Rawshan Khalid A, Alsuhaymi Nawaf Mohsen Mubarak, Aldossary Farha Abdullah K, Mohammed G Alkathiry Abdulrahman, Albishi Fayez Mubarak, Aljeddawi Jumana, Najm Fedaa Ahmed Omar, Najem Neda Ahmed, Almarhoon Mohamed Mirza Ali

机构信息

General Surgery, King Fahad Specialist Hospital, Tabuk, SAU.

General Practice, Al-Rayan Colleges, Al-Madinah Al-Munawwara, SAU.

出版信息

Cureus. 2024 Dec 21;16(12):e76123. doi: 10.7759/cureus.76123. eCollection 2024 Dec.

DOI:10.7759/cureus.76123
PMID:39840197
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11745840/
Abstract

Enhanced Recovery After Surgery (ERAS) protocols have significantly transformed the management of patients undergoing colorectal surgery. This comprehensive review explores the key components and benefits of ERAS in colorectal procedures, focusing on preoperative, perioperative, and postoperative strategies aimed at improving patient outcomes. These strategies include preoperative patient education, multimodal analgesia, minimally invasive surgical techniques, and early mobilization. ERAS protocols reduce postoperative complications, shorten hospital stays, and enhance overall recovery, leading to better patient satisfaction and decreased healthcare costs. However, challenges such as patient adherence and managing high-risk patients remain critical areas for further research. Additionally, future research should focus on refining ERAS protocols, integrating novel technologies such as minimally invasive techniques, and evaluating long-term outcomes to further enhance the recovery process.

摘要

术后加速康复(ERAS)方案显著改变了接受结直肠手术患者的管理方式。这篇综述探讨了ERAS在结直肠手术中的关键组成部分和益处,重点关注旨在改善患者预后的术前、围手术期和术后策略。这些策略包括术前患者教育、多模式镇痛、微创手术技术和早期活动。ERAS方案可减少术后并发症、缩短住院时间并促进整体康复,从而提高患者满意度并降低医疗成本。然而,患者依从性和高危患者管理等挑战仍是需要进一步研究的关键领域。此外,未来的研究应专注于完善ERAS方案、整合如微创手术技术等新技术,以及评估长期预后,以进一步优化康复过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23bd/11745840/03d734e9b656/cureus-0016-00000076123-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23bd/11745840/03d734e9b656/cureus-0016-00000076123-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23bd/11745840/03d734e9b656/cureus-0016-00000076123-i01.jpg

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本文引用的文献

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Efficacy and Safety of Ketamine-Dexmedetomidine Versus Ketamine-Propofol Combination for Periprocedural Sedation: A Systematic Review and Meta-analysis.氯胺酮-右美托咪定与氯胺酮-丙泊酚联合用于围手术期镇静的疗效和安全性:系统评价和荟萃分析。
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Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons.美国结肠和直肠外科医师协会以及美国胃肠和内镜外科医师协会发布的《结肠和直肠手术后加速康复临床实践指南》
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Long-term Bowel Dysfunction and Decline in Quality of Life Following Surgery for Colon Cancer: Call for Personalized Screening and Treatment.结直肠癌手术后长期肠道功能障碍和生活质量下降:呼吁进行个性化筛查和治疗。
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Future direction of Enhanced Recovery After Surgery (ERAS) program in colorectal surgery.结直肠手术中加速康复外科(ERAS)项目的未来发展方向。
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The impact of bowel dysfunction on health-related quality of life after rectal cancer surgery: a systematic review.直肠癌手术后肠道功能障碍对健康相关生活质量的影响:系统评价。
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Robotic versus conventional laparoscopic technique for the treatment of left-sided colonic diverticular disease: a systematic review with meta-analysis.机器人与传统腹腔镜技术治疗左侧结肠憩室病的比较:系统评价与荟萃分析。
Int J Colorectal Dis. 2022 Jan;37(1):101-109. doi: 10.1007/s00384-021-04038-x. Epub 2021 Oct 1.
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Implementation of an enhanced recovery after thoracic surgery care pathway for thoracotomy patients-achieving better pain control with less (schedule II) opioid utilization.为开胸手术患者实施强化术后康复护理路径——以更少的(II类)阿片类药物使用实现更好的疼痛控制。
J Thorac Dis. 2021 Jul;13(7):3948-3959. doi: 10.21037/jtd-21-552.
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Enhanced recovery after surgery: The road to improve peri-operative care globally.术后加速康复:全球改善围手术期护理之路。
Eur J Anaesthesiol. 2021 Sep 1;38(9):905-907. doi: 10.1097/EJA.0000000000001509.
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Enhanced recovery after surgery programs improve short-term outcomes after liver transplantation-A systematic review and meta-analysis.手术康复促进计划可改善肝移植术后的短期转归:系统评价和荟萃分析。
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