Effect of perioperative clinical application of enhanced recovery after surgery on elderly recipients undergoing liver transplantation
10.3969/j.issn.1674-7445.2023.02.016
- VernacularTitle:加速康复外科在老年肝移植受者围手术期临床应用中的效果
- Author:
Jianyu LIN
1
;
Chen CUI
;
Yanping GAO
;
Lin ZHOU
;
Wenli XU
;
Yuan WANG
Author Information
1. Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
- Publication Type:Research Article
- Keywords:
Enhanced recovery after surgery;
Liver transplantation;
Perioperative period;
Donation after cardiac death;
Venous thromboembolism;
Auxiliary ventilation;
Removal of drainage tube;
Delayed gastric emptying
- From:
Organ Transplantation
2023;14(2):288-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the application value of perioperative interventional strategy guided by enhanced recovery after surgery (ERAS) in elderly recipients undergoing liver transplantation. Methods Clinical data of 405 liver transplant recipients were retrospectively analyzed. According to age, all recipients were divided into the elderly (≥60 years, n=122) and non-elderly groups (< 60 years, n=283). All patients received perioperative interventions under the guidance of ERAS. Intraoperative and postoperative indexes, incidence of postoperative complications and discharge were analyzed between two groups. Results There were no significant differences in the duration of anesthesia, operation time, anhepatic phase, hemorrhage volume, blood transfusion volume, lactic acid level before abdominal closure, ventilator-assisted time, the length of intensive care unit (ICU) stay, Caprini score, CHIPPS score, time of gastric tube, urinary tube and drainage tube removal, time to first drinking, time to first physical activity and time to first flatus between two groups (all P > 0.05). In the elderly group, the time to first feeding was later than that in the non-elderly group (P < 0.05). There were no significant differences in the incidence of fever, ascites, pulmonary infection, delayed gastric emptying, hemorrhage and inactive venous thrombosis between two groups (all P > 0.05). No significant differences were observed in the levels of aspartate aminotransferase, total bilirubin, direct bilirubin, serum creatinine before discharge and total length of hospital stay between two groups (all P > 0.05). The alanine aminotransferase level in elderly recipients was lower than that in non-elderly counterparts, and the difference was statistically significant (P < 0.05). No unplanned reoperation was performed within postoperative 30 d in two groups. There was no significant difference in the re-hospitalization rate within 30 d after discharge (P > 0.05). Conclusions ERAS-guided interventional strategy contributes to perioperative recovery of elderly recipients undergoing liver transplantation, and yields equivalent postoperative recovery between elderly and non-elderly recipients.
