加速康复外科在前列腺癌根治术中的应用进展

A review of enhanced recovery after surgery in the application of radical prostatectomy

前列腺癌(Pca)发病率位居泌尿系统恶性肿瘤首位,严重危害人们的生命健康。前列腺癌根治术(RP)是局限性前列腺癌的主要治疗方式,以往RP大多伴随着较大的创伤和较长的恢复期。但随着近年来手术日益精细化和微创化的发展,加速康复理念应运而生。加速康复外科(ERAS)策略通过多个学科协作,对围术期进行干预和调控,从而达到加速患者术后康复、合理分配医疗资源等目的。尤其是在人们日益追求更高的生活医疗质量以及优质医疗资源紧缺的现今社会,ERAS策略被越来越多的学者认可并提倡。ERAS策略常规分为术前、术中、术后三个部分,包含了术前宣教、生理及心理准备、禁饮食、术前用药、麻醉方式、麻醉管理、手术入路、术中控液、术中保温、术后管道护理、术后镇痛、并发症管理、术后进食、术后活动等多个干预项目。本文主要就ERAS策略在前列腺癌根治手术中的应用进行综述。

The incidence of prostate cancer(PCa)ranks first among malignant tumors of the urinary system,seriously threating the lives and health of patients all over the world.Radical prostatectomy(RP)is the main treatment for localized prostate cancer.In the past,RP was usually accompanied by great trauma and long recovery periods.With the development of sophisticated and minimally invasive surgery in recent years,the concept of accelerated rehabilitation has emerged.With multidisciplinary cooperation to intervene and regulate the operation period,the enhanced rehabilitation after operation(ERAS)strategy can achieve the goal of accelerating the postoperative rehabilitation of patients and rationally allocating medical resources.Nowadays,with the increasingly pursuing higher quality of life and medical services of people,but short supply of high-quality medical resources,ERAS strategy has been recognized and promoted by more and more scholars.The ERAS strategy is routinely divided into three parts:preoperative,intraoperative,and postoperative,which includes preoperative education,physical and psychological preparation,preoperative medication,anesthesia methods,anesthesia management,surgical approach,intraoperative fluid control,Intraoperative heat preservation,postoperative pipeline care,postoperative analgesia,complication management,postoperative eating,postoperative activities and other intervention projects.This article mainly reviews and analyzes the various applications of ERAS strategy in radical prostatectomy.