快速康复医学在达芬奇机器人胃癌根治术中的应用

Application and effect of enhanced recovery after surgery on Da Vinci robotic gastrectomy

目的:评价加速康复外科(enhanced recovery after surgery,ERAS)在达芬奇机器人胃癌根治术中的可行性及有效性。方法:选取西安交通大学第一附属医院行达芬奇机器人胃癌根治术患者50例,其中25例采用胃癌术后常规围手术期护理模式,25例采用快速康复外科护理模式干预。比较两组患者手术时间、术中出血量、肛门排气时间、术后住院时间、术后炎症指标、术后住院费用、术后并发症情况等。结果:两组患者的一般病理特征并无显著差异(P>0.05)。在手术时间、术中出血量上比较,差异无统计学意义(P>0.05)。ERAS组在肛门排气时间、术后营养状态、术后炎症指标方面、术后住院时间、术后住院费用方面均较对照组显示出优势(均P<0.01);两组在术后并发症上并无统计学差异(P=0.554)。结论:ERAS理念在达芬奇机器人胃癌根治术中应用是安全、可靠的,且其与传统围手术期护理模式相比,在促进患者胃肠功能恢复、降低住院费用上具有一定优势。

Objective:To evaluate the feasibility and efficacy of Da Vinci robotic gastrectomy with an enhanced recovery after surgery(ERAS)program.Methods:This was a single institution prospective cohort study including all patients who underwent Da Vinci robotic gastrectomy as part of an ERAS program between January 1,2016 and March 1,2019 in the department of surgical oncology in the First Affiliated Hospital of Xi'an Jiaotong University.25 patients underwent Da Vinci robotic gastrectomy was adopted with routine perioperative intervention while 25 patients adopted the ERAS mode.Results:There were no significant differences in age,gender,BMI index,underlying disease,operation time and intraoperative blood loss between those two groups(P>0.05).The postoperative anal exhaust time of ERAS group was significantly faster than that of the traditional group(P<0.01).Compared with control group,ERAS concept showed its advantages in release postoperative inflammation,reduce postoperative hospitalization stay and cost(All P<0.01).There was no significant difference in postoperative complications between those two groups(P=0.554).Conclusion:Compared with routine perioperative intervention,ERAS nursing mode after Da Vinci robotic gastrectomy could improve the recovery of gastrointestinal function as well as reduce the hospitalization cost.In brief,ERAS nursing mode has a good clinical application prospects in Da Vinci robotic gastrectomy.