Shen Yun, Xi Yu, Ru Li Gu Xian, Liu Huayu
Department of Gastroenterology, The First Affiliated Hospital of Shihezi University, No. 107, Bei Er Road, Shihezi City, 832008, Xinjiang Uygur Autonomous Region, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China.
Langenbecks Arch Surg. 2025 Apr 21;410(1):135. doi: 10.1007/s00423-025-03652-5.
OBJECTIVE: This study aimed to evaluate the effectiveness of Enhanced Recovery After Surgery (ERAS)-based nursing interventions in improving postoperative recovery, reducing complications, and enhancing patient satisfaction and quality of life in patients undergoing endoscopic resection for early gastrointestinal tumors. METHODS: A single-center, randomized, single-blind controlled trial was conducted from October 2023 to October 2024 at a tertiary hospital. A total of 120 patients with early-stage gastrointestinal tumors scheduled for endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) were randomly assigned to the ERAS group (n = 60) or the control group (NC, n = 60). Data collection included Comprehensive Complication Index (CCI), Visual Analog Scale (VAS), Six-Minute Walk Test (6MWT), EORTC QLQ-C30, SF-36, patient satisfaction, and length of hospital stay. Statistical analyses included repeated measures ANOVA and chi-square tests, with a significance threshold of P < 0.05. RESULTS: Compared to the NC group, the ERAS group demonstrated significantly lower CCI scores and fewer Clavien-Dindo ≥ III complications at 3 days, 2 weeks, and 3 months postoperatively (P < 0.05). The ERAS group also reported shorter hospital stays (4.8 ± 1.5 vs. 6.3 ± 1.8 days, P < 0.001). VAS scores in the ERAS group were significantly lower at 24 h and 3 days postoperatively (P < 0.001), with differences diminishing over time. Functional recovery, measured by 6MWT, was significantly better in the ERAS group at all time points except 12 months. HRQoL scores in the ERAS group were significantly higher at 3 months, particularly in functional and symptom dimensions (P < 0.05), and have higher patient satisfaction rates across all follow-up time points (P < 0.05). CONCLUSION: ERAS-based nursing interventions significantly improved postoperative recovery, reduced complications, shortened hospital stays, and enhanced patient satisfaction and quality of life in patients undergoing minimally invasive endoscopic resection for early gastrointestinal tumors. These findings support the integration of ERAS principles into nursing care protocols to optimize surgical outcomes.
目的：本研究旨在评估基于加速康复外科（ERAS）的护理干预措施对接受早期胃肠道肿瘤内镜切除术患者术后恢复、减少并发症、提高患者满意度和生活质量的有效性。 方法：2023年10月至2024年10月在一家三级医院进行了一项单中心、随机、单盲对照试验。共有120例计划接受内镜黏膜下剥离术（ESD）或内镜黏膜切除术（EMR）的早期胃肠道肿瘤患者被随机分为ERAS组（n = 60）和对照组（NC，n = 60）。数据收集包括综合并发症指数（CCI）、视觉模拟量表（VAS）、6分钟步行试验（6MWT）、欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）、健康调查简表（SF-36）、患者满意度和住院时间。统计分析包括重复测量方差分析和卡方检验，显著性阈值为P < 0.05。 结果：与NC组相比，ERAS组在术后3天、2周和3个月时的CCI评分显著更低，Clavien-Dindo≥III级并发症更少（P < 0.05）。ERAS组的住院时间也更短（4.8±1.5天 vs. 6.3±1.8天，P < 0.001）。ERAS组术后24小时和3天时的VAS评分显著更低（P < 0.001），且差异随时间逐渐减小。除12个月外，ERAS组在所有时间点通过6MWT测量的功能恢复均显著更好。ERAS组在3个月时的健康相关生活质量评分显著更高，尤其是在功能和症状维度（P < 0.0），且在所有随访时间点的患者满意度更高（P < 0.05）。 结论：基于ERAS的护理干预措施显著改善了接受早期胃肠道肿瘤微创内镜切除术患者的术后恢复，减少了并发症，缩短了住院时间，提高了患者满意度和生活质量。这些发现支持将ERAS原则纳入护理方案以优化手术效果。
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