Enhanced recovery program in liver resection surgery: a single center experience
Enhanced recovery program in liver resection surgery: a single center experience
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肝切除手术加速康复计划：单中心经验
DOI：
10.21037/tcr.2018.08.30
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发表时间：
2018-08-01
影响因子：
0.9
通讯作者：
Wang, Weilin
中科院分区：
文献类型：
--
作者：
Ding, Yuan;Gao, Zhenzhen;Wang, Weilin
背景：ERAS （enhanced recovery after surgery）计划促进术后恢复。本研究旨在评估ERAS方案在肝切除术中的效果。方法：主要观察指标包括首次排气时间和住院时间（LOS）。次要结局包括第一次排便时间、下床活动时间、疼痛评分、腹胀评分、术后肝功能和并发症。结果在ERAS组（n=69）和对照组（n=232）之间进行评估。对ERAS组益生菌使用情况也进行了亚分析。结果：在行腹腔镜和开放式肝切除术的患者中，ERAS组术后首次放屁时间明显缩短，LOS也明显缩短。ERAS组术后并发症发生率较低。而益生菌组的亚分析对主要结局无显著影响。结论：在肝切除术中实施ERAS方案可显著促进术后恢复。ERAS组围手术期短期应用益生菌并没有改善预后。
Background: The enhanced recovery after surgery (ERAS) program promotes postoperative recovery. The study aimed to evaluate the effects of the ERAS protocol in hepatectomy.Methods: The primary outcomes included time to first flatus and length of hospital stay (LOS). Secondary outcomes included time to first passage of stool, time to off-bed activity, pain score, abdominal distension score, postoperative liver function and complications. Outcomes were evaluated between the ERAS group (n=69) and the control group (n=232). A subanalysis of probiotics use in the ERAS group was also performed.Results: In patients undergoing laparoscopic and open hepatectomy, time to first flatus after surgery was significantly shorter, as well as LOS, in the ERAS group. Lower incidence of post-operative complications was noted in ERAS group. While sub-analysis of probiotics group showed no significance in the primary outcomes.Conclusions: Implementation of the ERAS protocol for hepatectomy could significantly promote postoperative recovery. Short-term application of probiotics during the perioperative period did not improve the outcomes in the ERAS group.