ERAS在日间腹腔镜疝修补术治疗老年腹股沟疝中的应用

Application of Enhanced Recovery after Surgery in Daytime Laparoscopic Hernia Repair in Elderly Patients with Inguinal Hernia

目的探索加速康复外科(enhanced recovery after surgery,ERAS)理念在日间腹腔镜下经腹腹膜前疝修补术(transabdominal anterior hernia repair,TAPP)治疗老年腹股沟疝中的应用效果与临床价值。方法回顾性分析十堰市太和医院2020年9月—2022年3月收治的149例在日间手术模式下行TAPP的老年患者临床资料,根据采用ERAS日间手术模式或传统日间手术模式将患者分为ERAS组和对照组,比较两组患者一般资料、术后并发症、术后恢复情况等方面的差异。结果ERAS组患者的术前禁食水时间、术后首次进食时间及首次下地时间、术后恶心呕吐发生率、术后疼痛评分、住院费用以及出院后住院满意度要优于对照组患者,差异均具有统计学意义(P<0.05)。在术后并发症发生率,如尿潴留、术区皮下血肿、阴囊(大阴唇)水肿、术区切口感染、术区感觉异常、术后复发等的比较中,差异无统计学意义(P>0.05)。结论ERAS理念在日间腹腔镜疝修补术治疗老年腹股沟疝中的应用是安全、有效的,可以增加患者就医体验,加速患者术后康复,值得进一步的推广和应用。

Objective To explore the application effect and clinical value of enhanced recovery after surgery(ERAS)in the treatment of elderly inguinal hernia with daytime laparoscopic transabdominal preperitoneal(TAPP)repair.Methods The clinical data of 149 elderly patients who underwent TAPP in day surgery mode in Shiyan Taihe Hospital from September 2020 to March 2022 were retrospectively analyzed.According to the ERAS daytime surgery or traditional daytime surgery model,all patients were divided into ERAS group and the control group.The patients’general information,postoperative complications,and postoperative recovery were compared between two groups.Results Compared with the control group,the ERAS group had significantly better preoperative fasting time,postoperative first feeding time,first ambulation time,incidence of postoperative nausea and vomiting,postoperative pain score,hospitalization cost,and satisfaction with hospitalization after discharge(P<0.05).The incidence of postoperative complications,such as urinary retention area,subcutaneous hematoma,scrotal edema(labia majora),infection of incision,operation areas paresthesia,and postoperative recurrence,showed no significant differences between two groups(P>0.05).Conclusion The application of ERAS concept in the treatment of elderly inguinal hernia by daytime laparoscopic hernia repair is safe and effective,which can increase patients’medical experience and accelerate patients’postoperative recovery,and is worthy of further promotion and application.