加速康复外科在腹膜外免PORT单切口机器人辅助根治性前列腺切除术围手术期的应用效果

Application of ERAS in perioperative period of extraperitoneal PORT-free robot-assisted radical prostatectomy using single-incision

目的:探讨加速康复外科(ERAS)理念在未使用一次性多通道腹腔镜手术入路装置(以下简称PORT)情况下行腹膜外单切口机器人辅助根治性前列腺切除术(RARP)患者围手术期护理中的应用效果。方法:回顾性分析四川省人民医院机器人微创中心2022年1月—2022年7月接受腹膜外免PORT单切口RARP治疗的80例患者临床资料,依据随机数字表法分为两组,研究组(40例)按照加速康复外科理念护理,对照组(40例)进行常规外科护理。结果:80例手术均采用腹膜外免PORT单切口方式完成,研究组与对照组两组年龄、BMI、手术时间、术中出血量、即刻尿控满意率比较,差异均无统计学意义。研究组与对照组两组术后住院时间、导尿管留置时间、盆腔引流管留置时间、术后48 h疼痛评分、术后排气时间、下床活动时间、首次进食时间、术后并发症总发生率比较,差异均有统计学意义,且研究组优于对照组。结论:加速康复外科理念应用于腹膜外免PORT单切口RARP患者围手术期的护理,能有效缩短患者术后各种管道的留置时间、术后住院时间,促进胃肠功能早期恢复,降低并发症发生率,提高住院患者满意度。

Objective:To explore the effect of enhanced recovery after surgery(ERAS)in perioperative nursing care of patients underwent extraperitoneal PORT-free robot-assisted radical prostatectomy using single-incision.Methods:The clinical data of 80 patients who underwent extraperitoneal PORT-free single-incision robot-assisted laparoscopic radical prostatectomy(RARP)from January 2022 to July 2022 in the Robotic Minimally Invasive Surgery Center of Sichuan Provincial People’s Hospital was retrospectively analyzed.The 80 patients were divided into two groups using the random number table method.The study group(40 cases)were cared based on the concept of ERAS,the control group(40 cases)received routine surgical nursing.Results:All the surgeries were performed under extraperitoneal PORT-free single-incision.Ages,BMI,operative time,intraoperative blood loss and satisfaction rate of immediate continence of the two groups were compared,and the differences were not statistically significant.The length of hospital stay after surgery,the indwelling time of urinary catheter,the indwelling time of pelvic drainage tube,pain scores 48 h after surgery,the exhaust time after surgery,the time of out-of-bed activity,the time of first meal and the overall rate of postoperative complications in the study group and control group were compared,and the differences were statistically significant,the study group was better than the control group.Conclusion:Using the concept of ERAS in the perioperative nursing care of patients undergoing extraperitoneal PORT-free RARP with single-incision could effectively shorten the indwelling time of different catheters and length of hospital stay,accelerate recovery of intestinal function,reduce the incidence of complications and improve the satisfaction degree of inpatients.