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肝切除手术中强化康复计划的依从性:一项回顾性队列研究。

Compliance to enhanced recovery program in liver resection surgery: A retrospective cohort study.

作者信息

Pradhan Abiya, Sarkar Anshuman, Haldar Srimanta, Chakraborty Arunangshu, Pal Angshuman Rudra

机构信息

Department of Onco-Anaesthesia, Tata Medical Center, Kolkata, West Bengal, India.

出版信息

J Anaesthesiol Clin Pharmacol. 2025 Apr-Jun;41(2):318-322. doi: 10.4103/joacp.joacp_5_24. Epub 2024 May 23.

Abstract

BACKGROUND AND AIMS

Liver resection is a complex surgery, and optimizing recovery is critical to ensure that patients can promptly regain their health and quality of life. The authors present a retrospective cohort study on Enhanced Recovery After Surgery (ERAS) in liver resection aimed at correlating compliance with ERAS elements to length of stay (LOS) and the incidence of complications in a tertiary-level cancer hospital in Eastern India.

MATERIAL AND METHODS

In total, 44 hepatectomy patients were assessed retrospectively from June 2022 to May 2023. Data were collected from electronic medical records and patient charts.

RESULTS

The overall compliance was 77.7%. Individual component compliance varied. Lower compliance rates were seen with some aspects such as fasting and carbohydrate loading, minimally invasive surgical techniques used, and avoidance or early removal of the drain. The cohort was divided into two groups. Group 1 had compliance to ≥75% of 21 elements of ERAS, and group 2 had compliance to <75%. Statistical analysis showed higher ERAS compliance and reduced complications, although LOS differences were not statistically significant (group 1 and group 2 with an LOS difference of 1 day). Severe complications such as re-exploration and death were noted in the group of patients with compliance to less than 75% of the components.

CONCLUSION

With increased ERAS compliance, the patients benefited clinically and financially.

摘要

背景与目的

肝切除术是一项复杂的手术,优化术后恢复对于确保患者能够迅速恢复健康和生活质量至关重要。作者开展了一项关于肝切除术后加速康复(ERAS)的回顾性队列研究,旨在将印度东部一家三级癌症医院中ERAS要素的依从性与住院时间(LOS)及并发症发生率相关联。

材料与方法

2022年6月至2023年5月期间,对44例肝切除患者进行了回顾性评估。数据从电子病历和患者病历中收集。

结果

总体依从率为77.7%。各个组成部分的依从性各不相同。在禁食和碳水化合物负荷、所采用的微创手术技术以及避免或早期拔除引流管等某些方面,依从率较低。该队列被分为两组。第1组对21项ERAS要素的依从率≥75%,第2组对这些要素的依从率<75%。统计分析表明,ERAS依从性越高,并发症越少,尽管住院时间差异无统计学意义(第1组和第2组的住院时间相差1天)。在对不到75%的组成部分依从的患者组中,观察到了再次手术和死亡等严重并发症。

结论

随着ERAS依从性的提高,患者在临床和经济方面均受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4827/12002699/b733a0f4de2f/JOACP-41-318-g002.jpg

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