Abstract:
OBJECTIVE: Enhanced Recovery After Surgery (ERAS) is a modern concept that aims to improve the perioperative patient care by implementing an evidence-based, patient-centered team approach. This paper aims to analyze the outcome, variations and limits of the ERAS-protocols used for laparoscopic cholecystectomy. Methods: We performed a systematic review on PubMed, Google Scholar, Web of Science to document the outcomes of applying various ERAS protocols in laparoscopic cholecystectomy (LC). After applying the inclusion and exclusion criteria, 8 papers, totaling 1453 patients that underwent LC, were included in the qualitative analysis. ERAS-protocols applied in those studies include various pre-, intra- and postoperative measures intended to boost the surgical recovery of the patients and shorten their hospital stay, without exposing them to hazardous encounters. Results: Patients undergoing laparoscopic cholecystectomy within an ERAS-specific protocol are proven to have lower levels of postoperative pain, nausea and vomiting, with no statistically significant risk of postoperative complications. The postoperative results show that ERAS-laparoscopic cholecystectomy is a feasible and safe procedure, that may shorten the postoperative recovery after LC. Conclusions: Further studies are needed to establish a consensus regarding the perioperative protocol, before implementing ERAS for LC in clinical routine.
摘要:
目的:增强手术后恢复(ERAS)是一个现代概念,旨在通过实施循证,以患者为中心的团队方法。本文旨在分析结果,用于腹腔镜胆囊切除术的ERAS方案的变化和限制。方法:我们对PubMed进行了系统评价,谷歌学者,WebofScience记录了在腹腔镜胆囊切除术(LC)中应用各种ERAS协议的结果。在应用纳入和排除标准后,8篇论文共有1453例患者接受LC,都包括在定性分析中。在这些研究中应用的ERAS协议包括各种前,术中和术后措施旨在促进患者的手术恢复并缩短其住院时间,不会让他们面临危险的遭遇。结果:在ERAS特异性方案中接受腹腔镜胆囊切除术的患者被证明术后疼痛水平较低,恶心和呕吐,术后并发症的风险无统计学意义。术后结果表明,ERAS-腹腔镜胆囊切除术是一种可行和安全的手术,这可能会缩短LC术后恢复时间。结论:需要进一步的研究来建立关于围手术期方案的共识,在临床常规中实施LCERAS之前。