加速康复外科理念中的微创手术

Minimally invasive surgery in the concept of enhanced recovery after surgery

加速康复外科(ERAS)和微创外科是引领21世纪现代外科学进步的两个重要发展方向,其为手术患者的快速康复及医疗资源的更合理利用,提供了新的临床治疗方法及理论依据,是手术相关学科的临床研究和学术交流的两大热点内容,并推动了外科各专业的快速发展。ERAS包含了术前、术中、术后等一系列优化措施,其中微创手术作为术中优化的一个重要环节。手术质量好坏、特别是微创手术,对术后患者的康复起到关键性作用,是ERAS重中之重的措施。ERAS与微创外科联合应用不仅安全可行,而且有利于提高或改善术后患者的近远期疗效。采取微创手术联合ERAS管理,将使患者切口更小,创伤应激反应更小,更好的手术耐受能力,术后疼痛减轻,更早期的下地活动,更快的器官功能恢复,且会减少并发症的发生。总之,ERAS与微创外科是相辅相成、相互促进的,两者作为现代医学的两大杰出成果,为现代外科学的发展开拓了新篇章。

Enhanced recovery after surgery(ERAS)and minimally invasive surgery are two important development directions of modern surgery in the 21st century.They provide new clinical treatment methods and theoretical basis for the rapid recovery of surgical patients and more rational utilization of medical resources.They are two hot topics in clinical research and academic exchange of surgery-related subjects,and promote the rapid development and clinical application of surgery.ERAS covers a range of preoperative,intraoperative,and postoperative optimization measures,of which minimally invasive surgery is an important part of intraoperative optimization.The quality of surgery,especially minimally invasive surgery,plays a key role in postoperative recovery,which is the most important one of all ERAS measures.With good surgical quality and no postoperative complications,patients will recover quickly.Therefore,minimally invasive surgery plays a central role in the ERAS concept.The combination of ERAS with minimally invasive surgery is not only safe and feasible,but is also better than these two clinical therapies alone for postoperative recovery,and improves short-term and long-term outcome and accelerates the recovery of patients.For surgical diseases treated with minimally invasive surgery as far as possible,using the ERAS management for patients will result in reduced traumatic stress,better surgical tolerance,less postoperative pain,smaller incision,earlier ambulation,better organ function,and less morbidity of complications.In short,ERAS and minimally invasive surgery complement and promote each other.As two outstanding achievements of modern medicine,they are clinical treatments that provide sufficient theoretical basis for rapid recovery of patients and open a new chapter for the development of modern surgery.