Clinical application of modified enhanced recovery after surgery management in perioperative period of robot-assisted laparoscopic radical prostatectomy
- VernacularTitle:改良加速康复外科管理在机器人辅助腹腔镜前列腺癌根治术围术期的临床应用研究
- Author:
Ye LU
1
;
Han HAN
;
Nana WANG
Author Information
- Keywords: prostate cancer; robot-assisted laparoscopic radical prostatectomy; enhanced re-covery after surgery; composite warming; anesthesia management; physiological stress; coagulation function; complications
- From: Journal of Clinical Medicine in Practice 2025;29(20):1-6,13
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the clinical application value of modified and optimized en-hanced recovery after surgery(ERAS)management in the perioperative period of patients undergoing robot-assisted laparoscopic radical prostatectomy(RLRP).Methods A total of 100 RLRP patients were selected as the research subjects and randomly divided into conventional group(receiving con-ventional ERAS management)and research group(receiving modified and optimized ERAS manage-ment)using the random number table method,with 50 cases in each group.Perioperative indicators,the use of anesthetic drugs,and the levels of physiological stress indicators[cortisol(Cor),norepi-nephrine(NE),plasma renin activity(PRA)]and coagulation function indicators[prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)]before and after surgery were compared between the two groups.The incidence of postoperative complications and the readmis-sion rate within 30 days after surgery were also statistically analyzed.Results The intraoperative fluid infusion volume in the research group was less than that in the conventional group.The postoperative time to get out of bed,time to first flatus,pelvic drainage tube retention time,and hospital stay in the research group were horter than those in the conventional group(P＜0.05).The incidence of intraoperative hypothermia in the research group was lower than that in the conventional group,with statistically significant differences(P＜0.05).The doses of propofol and cisatracurium in the re-search group were less than those in the conventional group,with statistically significant differences(P＜0.05).After surgery,the levels of Cor,NE and PRA in both groups were higher than those before surgery,but they were lower in the research group than those in the conventional group,with statistically significant differences(P＜0.05).After surgery,the TT,PT and APTT in both groups were longer than those before surgery,but they were shorter in the research group than those in the conventional group,with statistically significant differences(P＜0.05).The overall incidence of complications in the research group was lower than that in the conventional group,with a statistically significant difference(P＜0.05).There was no statistically significant difference in the readmission rate within 30 days after surgery between the two groups(P＞0.05).Conclusion Modified and optimized ERAS management can effectively promote rapid postoperative recovery in RLRP patients,reduce the doses of anesthetic drugs and fluid infusion volume,alleviate physiological stress respon-ses,improve the body's coagulation function,and reduce the risk of complications.
