1.Application of enhanced recovery after surgery in the treatment of children with congenital choledochal cyst.
Hangyan ZHAO ; Duote CAI ; Zhigang GAO ; Qingjiang CHEN ; Jihua ZHU ; Jinjin HUANG
Journal of Zhejiang University. Medical sciences 2019;48(5):474-480
OBJECTIVE:
To explore the feasibility of enhanced recovery after surgery (ERAS) in treatment of children with congenital choledochal cyst.
METHODS:
One hundred and thirty children with congenital choledochal cysts admitted in the Children's Hospital of Zhejiang University from June 2017 to June 2019 were divided into ERAS group (=65) and control group (=65) according to admission order. The intestinal tract condition during operation, time of operation, surgical results, time for eating after operation, abdominal drainage after operation, length of hospital stay after operation, total hospital expenses and complications were compared between two groups.
RESULTS:
Compared with the control group, the satisfaction of intestinal operation field, recovery of gastrointestinal function after operation,time required for the volume of peritoneal drainage fluid to be less than 50 mL,time of abdominal drainage tube removal, and length of hospital stay were all improved in ERAS group (<0.05 or <0.01).ERAS group had more peritoneal effusion after removal of abdominal drainage tube (<0.01), but the incidence of edema after operation was lower (<0.05). The satisfaction of parents in the two groups was similar, but the cooperation of parents in the ERAS group was improved (<0.05) and the total cost of hospitalization was reduced (<0.01).
CONCLUSIONS
ERAS has advantages over the traditional scheme and can be used in the clinical treatment of children with congenital choledochal cyst.
Case-Control Studies
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Child
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Choledochal Cyst
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economics
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surgery
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Enhanced Recovery After Surgery
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standards
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Humans
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Length of Stay
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Postoperative Complications
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prevention & control
2.Expert consensus of perioperative management in pediatric liver transplantation.
Chinese Journal of Surgery 2021;59(3):179-191
Pediatric liver transplantation (PLT) is an effective strategy of treating various acute or chronic end-stage liver diseases and inherited metabolic diseases in children.PLT has been applied in many transplant centers nationwide and has achieved satisfactory results.However,the development of transplant centers is uneven,and there is a lack of consensus and standards within the industry.In order to reduce post-operative complications,accelerate post-operative recovery,and improve the short-and long-term quality of life of children,the Enhanced Recovery After Surgery Committee of Chinese Research Hospital Association organized multidisciplinary experts to summarize the progress of domestic and international research,and formulated a perioperative consensus on PLT based on the principles of evidence-based medicine.The consensus provides recommendations for perioperative PLT from three aspects:preoperative assessment and preparation,intraoperative management and postoperative management,in order to provide reference guidelines for centers that are conducting or preparing to conduct PLT.
Child
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Consensus
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End Stage Liver Disease/therapy*
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Enhanced Recovery After Surgery/standards*
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Humans
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Liver Transplantation/standards*
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Metabolism, Inborn Errors/therapy*
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Perioperative Care/standards*
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Practice Guidelines as Topic