PDF(Pubmed)
Abstract：
BACKGROUND: In recent years, enhanced recovery after surgery (ERAS) guidelines have been developed to optimize pre-, intra-, and postoperative care of surgical oncology patients. The aim of this study was to compare management outcome of patients undergoing head and neck cancer (HNC) surgery with free flap reconstruction at our institution before and after the implementation of the ERAS guidelines.
METHODS: This retrospective study comprised 283 patients undergoing HNC surgery with free flap reconstruction between 2013 and 2020. Patients operated before and after the implementation of the ERAS protocol in October 2017 formed the pre-ERAS group (n = 169), and ERAS group (n = 114), respectively.
RESULTS: In the pre-ERAS group the mean length of stay (LOS) and intensive care unit length of the stay (ICU-LOS) were 20 days (range 7-79) and 6 days (range 1-32), and in the ERAS group 13 days (range 3-70) and 5 days (range 1-24), respectively. Both LOS (p < 0.001) and ICU-LOS (p = 0.042) were significantly reduced in the ERAS group compared to the pre-ERAS group. There were significantly fewer medical complications in the ERAS group (p < 0.003). No difference was found between the study groups in the surgical complication rate or in the 30-day or 6-month mortality rate after surgery.
CONCLUSIONS: We found reduced LOS, ICU-LOS, and medical complication rate, but no effect on the surgical complication rate after implementation of the ERAS guidelines, which supports their use in major HNC surgery.
METHODS: This retrospective study comprised 283 patients undergoing HNC surgery with free flap reconstruction between 2013 and 2020. Patients operated before and after the implementation of the ERAS protocol in October 2017 formed the pre-ERAS group (n = 169), and ERAS group (n = 114), respectively.
RESULTS: In the pre-ERAS group the mean length of stay (LOS) and intensive care unit length of the stay (ICU-LOS) were 20 days (range 7-79) and 6 days (range 1-32), and in the ERAS group 13 days (range 3-70) and 5 days (range 1-24), respectively. Both LOS (p < 0.001) and ICU-LOS (p = 0.042) were significantly reduced in the ERAS group compared to the pre-ERAS group. There were significantly fewer medical complications in the ERAS group (p < 0.003). No difference was found between the study groups in the surgical complication rate or in the 30-day or 6-month mortality rate after surgery.
CONCLUSIONS: We found reduced LOS, ICU-LOS, and medical complication rate, but no effect on the surgical complication rate after implementation of the ERAS guidelines, which supports their use in major HNC surgery.
摘要：
背景：近年来，已经制定了增强术后恢复(ERAS)指南来优化前，intra-,以及肿瘤外科患者的术后护理。这项研究的目的是比较在实施ERAS指南之前和之后在我们机构接受头颈部癌（HNC）手术和游离皮瓣重建的患者的治疗结果。
方法：这项回顾性研究包括2013年至2020年期间接受HNC手术和游离皮瓣重建的283例患者。在2017年10月实施ERAS方案之前和之后进行手术的患者组成了ERAS前小组（n=169），和ERAS组（n=114），分别。
结果：在ERAS之前组，平均住院时间（LOS）和重症监护病房住院时间（ICU-LOS）分别为20天（范围7-79）和6天（范围1-32），在ERAS组13天（范围3-70）和5天（范围1-24），分别。与前ERAS组相比，ERAS组的LOS（p<0.001）和ICU-LOS（p=0.042）均显着降低。ERAS组的并发症明显较少（p<0.003）。研究组之间的手术并发症发生率或术后30天或6个月的死亡率没有差异。
结论：我们发现LOS降低，ICU-LOS,和医疗并发症发生率，但实施ERAS指南后对手术并发症发生率没有影响，这支持它们在大型HNC手术中的使用。
方法：这项回顾性研究包括2013年至2020年期间接受HNC手术和游离皮瓣重建的283例患者。在2017年10月实施ERAS方案之前和之后进行手术的患者组成了ERAS前小组（n=169），和ERAS组（n=114），分别。
结果：在ERAS之前组，平均住院时间（LOS）和重症监护病房住院时间（ICU-LOS）分别为20天（范围7-79）和6天（范围1-32），在ERAS组13天（范围3-70）和5天（范围1-24），分别。与前ERAS组相比，ERAS组的LOS（p<0.001）和ICU-LOS（p=0.042）均显着降低。ERAS组的并发症明显较少（p<0.003）。研究组之间的手术并发症发生率或术后30天或6个月的死亡率没有差异。
结论：我们发现LOS降低，ICU-LOS,和医疗并发症发生率，但实施ERAS指南后对手术并发症发生率没有影响，这支持它们在大型HNC手术中的使用。
