Shi Youwen, Bian Wenxia, Wang Shangqian
The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
J Robot Surg. 2025 Jun 5;19(1):270. doi: 10.1007/s11701-025-02428-9.
Robotic-assisted radical prostatectomy (RARP) frequently leads to postoperative gastrointestinal complications, delaying recovery. This study assessed the effectiveness of combining the LEARNS nursing model with auricular acupressure and intestinal rehabilitation techniques to enhance postoperative recovery in RARP patients. A randomized controlled trial was conducted involving 256 male patients undergoing RARP. Participants were randomly assigned to either an intervention group (n = 128), receiving the LEARNS model combined with auricular acupressure and intestinal rehabilitation nursing, or a control group (n = 128), receiving conventional postoperative care. Primary outcomes included the time to first postoperative exhaust, bowel sound recovery, first defecation, severity of abdominal distension, and duration of hospital stay. Compared to the control group, the intervention group demonstrated significantly shorter bowel sound recovery time (4.45 ± 0.87 vs. 5.21 ± 1.02 h, P < 0.001), earlier first exhaust (24.35 ± 2.75 vs. 30.25 ± 2.15 h, P < 0.001), and earlier first defecation (75.35 ± 4.23 vs. 83.52 ± 6.53 h, P < 0.001). The intervention group also experienced significantly reduced severity of abdominal distension and shorter postoperative hospital stays (5.28 ± 1.22 vs. 6.56 ± 1.08 days, P < 0.001). Integrating the LEARNS nursing model with auricular acupressure and intestinal rehabilitation substantially accelerates gastrointestinal recovery following RARP. Embedding this evidence-based, multimodal nursing protocol into routine perioperative care pathways may reduce postoperative morbidity, shorten hospital stay, and optimise healthcare resource utilisation, thereby providing considerable clinical value.
机器人辅助根治性前列腺切除术(RARP)常常导致术后胃肠道并发症,延缓康复。本研究评估了将LEARNS护理模式与耳穴按压及肠道康复技术相结合,对促进RARP患者术后康复的有效性。进行了一项随机对照试验,纳入256例接受RARP的男性患者。参与者被随机分为干预组(n = 128),接受LEARNS模式联合耳穴按压及肠道康复护理,或对照组(n = 128),接受常规术后护理。主要结局包括术后首次排气时间、肠鸣音恢复、首次排便、腹胀严重程度及住院时间。与对照组相比,干预组肠鸣音恢复时间显著缩短(4.45±0.87 vs. 5.21±1.02小时,P < 0.001),首次排气更早(24.35±2.75 vs. 30.25±2.15小时,P < 0.001),首次排便更早(75.35±4.23 vs. 83.52±6.53小时,P < 0.001)。干预组腹胀严重程度也显著降低,术后住院时间更短(5.28±1.22 vs. 6.56±1.08天,P < 0.001)。将LEARNS护理模式与耳穴按压及肠道康复相结合可显著加速RARP术后胃肠道恢复。将这种基于证据的多模式护理方案纳入常规围手术期护理路径,可能会降低术后发病率,缩短住院时间,优化医疗资源利用,从而具有相当大的临床价值。