Application of enhanced recovery after surgery in perioperative management of patients with gallbladder carcinoma.
10.3760/cma.j.cn112139-20220107-00013
- VernacularTitle:围手术期加速康复外科理念用于胆囊癌患者的诊治经验初探
- Author:
Xin WU
1
;
Bing Lu LI
1
;
Jia SUN
1
;
Chao Ji ZHENG
1
;
Xiao Dong HE
1
;
Wei LIU
1
;
Tao HONG
1
;
Xian Lin HAN
1
Author Information
1. Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China.
- Publication Type:Journal Article
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Enhanced Recovery After Surgery;
Female;
Gallbladder Neoplasms/surgery*;
Humans;
Length of Stay;
Male;
Middle Aged;
Postoperative Complications;
Propensity Score;
Retrospective Studies;
Treatment Outcome
- From:
Chinese Journal of Surgery
2022;60(4):372-377
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the efficacy and safety of enhanced recovery after surgery (ERAS) in perioperative management of patients with gallbladder carcinoma. Methods: The data of the patients with gallbladder carcinoma admitted at Peking Union Medical College Hospital between January 2017 and December 2021 were analyzed retrospectively. There were 69 males(42.1%) and 95 females(57.9%),with age of (64.0±10.3) years(range:37 to 89 years). Patients were divided into ERAS group(n=53) and normal group(n=111) according to whether they were treated with ERAS measures during the perioperative period.The basic characteristics of the two groups were matched by propensity score matching,and then the perioperative information was compared between the two groups. Categorical variables were presented as absolute numbers or frequencies. Differences between study groups were analyzed using χ2 test, Fisher's exact test, t-test, or Mann-Whitney U test, as appropriate. Results: Each group had 45 patients after propensity score matching with well-balanced basic characteristics. There was no difference in basic characteristics, operation time,bleeding,complication,and hospitalization expenses between two groups(all P>0.05). Compared with the normal group,time of ambulation (M(IQR)) (1(1) day vs. 2(2) days;Z=-3.839,P<0.01),postoperative anal exhaust time (2(1) days vs. 3(1) days;Z=-3.013,P=0.003),feeding time(2(1) days vs. 2(1) days;Z=-3.647,P<0.01),postoperative (5(2) days vs. 7(4) days;Z=-3.984,P<0.01) and total(8(4) days vs. 13(6) days;Z=-3.605,P<0.01) hospitalization time were shorter in ERAS group. Postoperative complications occurred in 12 patients. According to the Clavien-Dindo classification,6,4,and 2 patients were classified as grade Ⅰ,Ⅱ,and Ⅲa,respectively. Conclusion: The ERAS measures is safe and effective for perioperative management of patients with gallbladder carcinoma, enhancing patient recovery and shortening hospitalization time without increasing complication or hospitalization cost.
