应用加速康复外科理念的机器人辅助腹腔镜前列腺癌根治术

Implementation of enhanced recovery after surgery protocols to robot-assisted laparoscopic radical prostatectomy

目的探讨应用加速康复外科(ERAS)理念的机器人辅助腹腔镜前列腺癌根治术(RARP)的安全性和优越性。方法回顾性分析2014年9月-2018年3月该院施行的490例RARP患者的临床资料。ERAS组230例采用ERAS处理方案,对照组260例围术期采用传统处理方案。使用SPSS 20.0进行数据分析。结果两组术中失血量、输血率、再手术率、肠粘连、肠梗阻、肺炎、肺栓塞(PTE)、下肢深静脉血栓(DVT)和30 d再入院率等比较,差异均无统计学意义(P>0.05)。ERAS组术后疼痛数字评分(NRS)低于对照组(P <0.05);首次肛门排气时间(P <0.05)、首次排便时间(P <0.05)早于对照组;住院天数(P <0.05)短于对照组。结论应用ERAS理念行RARP安全有效,降低了术后疼痛反应,肠道功能恢复更快,可促进患者早日康复,缩短了住院时间。

Objective To discuss the safety and superiority of the enhanced recovery after surgery(ERAS)in patients with Robot-Assisted Radical Prostatectomy(RARP). Methods A retrospective analysis of consecutive 490 patients from September 2014 to March 2018 underwent RARP, 230 patients were treated with ERAS as ERAS group, 260 patients were treated with traditional treatment as control group. All the data were calculated by using SPSS 20.0 software. Results Blood loss, transfusion rates, incidence of reoperation, incidence of intestinal adhesion,incidence of intestinal obstruction, pneumonia, pulmonary embolism, deep venous thrombosis, 30-Day Readmissions did not differ with ERAS use(all P > 0.05). The NRS pain score(P < 0.05) was lower in ERAS group;The first anal exhaust time(P < 0.05), the first defecation time(P < 0.05) and length of stay(P < 0.05) was shorter with ERAS than those without. Conclusions The use of ERAS pathways was safe and practicable for patients undergoing RARP.Recovery after RARP surgery can be improved by using enhanced recovery pathways. This adoption should be encouraged.