PDF(Pubmed)
Abstract：
BACKGROUND: The enhanced recovery after surgery (ERAS®) is a multimodal perioperative care pathway designed to reduce surgical stress and ultimately improve patient recovery and outcome. It can require significant resources but with proven benefits. The main goal of this study was to perform a diagnostic assessment of perioperative practice in a local colorectal surgical center.
METHODS: 93 patients who underwent elective colorectal surgery from January to December 2022 were analyzed. Preadmission, preoperative, and postoperative data of all patients were collected in a database developed by the researchers, according to ERAS® guidelines. Descriptive statistics were employed to summarize demographic and clinical characteristics. Chi-square and T-test were performed to identify possible associations between categorical variables and postoperative complications.
RESULTS: Overall analysis showed deficient preoperative patient optimization, especially regarding nutritional counseling and supplementation, smoking and alcohol cessation, anemia treatment (9%), and pre-anesthetic medication (42%). Removal of invasive devices was significantly delayed (removal of urinary catheter average on the fourthday and surgical drain average on the fifth day) in the postoperatively period and oral intake (average onset on the sixth day). Both contribute to hospital length of stay (mean of 13 days) and a significant number of complications.
CONCLUSIONS: The results lead us to an individual and multidisciplinary reflection on current practices and outcomes. ERAS® program, already adopted by many centers, could have a positive impact on the immediate postoperative recovery of colorectal patients in Funchal Central Hospital and implementation seems necessary.
METHODS: 93 patients who underwent elective colorectal surgery from January to December 2022 were analyzed. Preadmission, preoperative, and postoperative data of all patients were collected in a database developed by the researchers, according to ERAS® guidelines. Descriptive statistics were employed to summarize demographic and clinical characteristics. Chi-square and T-test were performed to identify possible associations between categorical variables and postoperative complications.
RESULTS: Overall analysis showed deficient preoperative patient optimization, especially regarding nutritional counseling and supplementation, smoking and alcohol cessation, anemia treatment (9%), and pre-anesthetic medication (42%). Removal of invasive devices was significantly delayed (removal of urinary catheter average on the fourthday and surgical drain average on the fifth day) in the postoperatively period and oral intake (average onset on the sixth day). Both contribute to hospital length of stay (mean of 13 days) and a significant number of complications.
CONCLUSIONS: The results lead us to an individual and multidisciplinary reflection on current practices and outcomes. ERAS® program, already adopted by many centers, could have a positive impact on the immediate postoperative recovery of colorectal patients in Funchal Central Hospital and implementation seems necessary.
摘要：
背景：增强术后恢复（ERAS®）是一种多模式的围手术期护理途径，旨在减轻手术压力并最终改善患者的康复和预后。它可能需要大量资源，但具有已证明的好处。这项研究的主要目的是对当地结直肠外科中心的围手术期实践进行诊断评估。
方法：对2022年1月至12月行择期结直肠手术的93例患者进行分析。预存,术前,所有患者的术后数据都收集在研究人员开发的数据库中，根据ERAS®指南。描述性统计用于总结人口统计学和临床特征。进行卡方和T检验以确定分类变量与术后并发症之间的可能关联。
结果：总体分析显示患者术前优化不足，特别是关于营养咨询和补充，戒烟和戒酒,贫血治疗（9%），和麻醉前药物(42%)。在术后期间和口服摄入（平均在第六天开始），侵入性装置的移除显着延迟（在第四天平均移除导尿管，在第五天平均移除手术引流）。两者都导致住院时间（平均13天）和大量并发症。
结论：结果引导我们对当前实践和结果进行个人和多学科的反思。ERAS®计划,已经被许多中心采用，可能对丰沙尔中心医院结直肠患者的术后即刻恢复产生积极影响，实施似乎有必要。
方法：对2022年1月至12月行择期结直肠手术的93例患者进行分析。预存,术前,所有患者的术后数据都收集在研究人员开发的数据库中，根据ERAS®指南。描述性统计用于总结人口统计学和临床特征。进行卡方和T检验以确定分类变量与术后并发症之间的可能关联。
结果：总体分析显示患者术前优化不足，特别是关于营养咨询和补充，戒烟和戒酒,贫血治疗（9%），和麻醉前药物(42%)。在术后期间和口服摄入（平均在第六天开始），侵入性装置的移除显着延迟（在第四天平均移除导尿管，在第五天平均移除手术引流）。两者都导致住院时间（平均13天）和大量并发症。
结论：结果引导我们对当前实践和结果进行个人和多学科的反思。ERAS®计划,已经被许多中心采用，可能对丰沙尔中心医院结直肠患者的术后即刻恢复产生积极影响，实施似乎有必要。
