Xu Jia-Jing, Tang Xiao-Ting, Mao Mao, Yang Qi-Ning, Jiang Lian-Ping, Fu Wei-Cong, Zhou Yong-Wei, Ye Xiang-Hong
Orthopedic Department, Jinhua Hospital of Zhejiang University, Jinhua Municipal Central Hospital, Jinhua, Zhejiang, China.
Front Surg. 2025 May 19;12:1554301. doi: 10.3389/fsurg.2025.1554301. eCollection 2025.
Enhanced recovery after surgery (ERAS) has significantly benefited patients and healthcare systems; however, improvements are required, particularly in patient optimization and system implementation. Hospitals, as the main sites for medical activities, can coordinate cooperation among different departments and strategically organize various components of ERAS.
In March 2023, Jinhua Municipal Central Hospital initiated a comprehensive ERAS program, focusing on fluid and food restriction as the first task assigned. The aim was to reduce the preoperative fasting time throughout the hospital and enhance patients' preoperative experience. We selected data from the hospital for the first quarter of 2023 as the control group and data from the second and third quarters after the ERAS program implementation as the experimental groups. The collected data included preoperative liquid fasting time (PLFt), preoperative solid fasting time (PSFt), preoperative feeling of hunger (PFoH), and preoperative feeling of thirst (PFoT).
Our study included 24,829 cases. Eight departments included in the statistics revealed a significant reduction in preoperative fasting time, while the reduction of PLFt was more significant. The preoperative feeling of patients was significantly improved, which suggested that the incidence of PFoH and PFoT decreased.
In conclusion, implementing hospital-mediated ERAS is a feasible approach to effectively mobilize resources across departments, coordinate efforts, and address challenges in ERAS implementation. However, the long-term benefits of hospital-mediated ERAS initiatives require comprehensive ERAS protocols and longer follow-up studies for clarity. Additionally, the ERAS procedures need further improvements.
术后加速康复(ERAS)已使患者和医疗系统显著受益;然而,仍需改进,特别是在患者优化和系统实施方面。医院作为医疗活动的主要场所,能够协调不同科室之间的合作,并从战略上组织ERAS的各个组成部分。
2023年3月,金华市中心医院启动了一项全面的ERAS计划,将限制液体和食物摄入作为首要任务。目的是缩短全院患者的术前禁食时间,并提升患者的术前体验。我们选取了该医院2023年第一季度的数据作为对照组,将ERAS计划实施后的第二和第三季度的数据作为实验组。收集的数据包括术前液体禁食时间(PLFt)、术前固体禁食时间(PSFt)、术前饥饿感(PFoH)和术前口渴感(PFoT)。
我们的研究纳入了24829例病例。纳入统计的8个科室显示术前禁食时间显著缩短,其中PLFt缩短更为明显。患者的术前感受显著改善,这表明PFoH和PFoT的发生率降低。
总之,实施医院主导的ERAS是一种可行的方法,能够有效调动各部门资源、协调各方努力并应对ERAS实施过程中的挑战。然而,医院主导的ERAS举措的长期益处需要全面的ERAS方案和更长时间的随访研究来明确。此外,ERAS流程还需要进一步改进。