■研究小儿结肠造口闭合手术后增强恢复(ERAS)方案的安全性和可行性。
■对接受结肠造口术闭合的儿童进行回顾性观察研究。数据是从2013年10月至2023年10月在某高等医学院小儿外科的电子病历和患者的电话随访电话中收集的。获得的参数是年龄,性别,造口的类型,初步诊断,管腔直径的差异,时间达到完全的饲料,术后住院时间,和并发症。结肠造口术闭合所遵循的方案包括以下-没有肠道准备或鼻胃管,没有过夜禁食,单剂量的抗生素预防,避免使用阿片类药物,填充近端气孔,直到动员并在术后开始早期口服进食。连续参数表示为平均值±标准偏差或中值(范围),而描述性参数表示为数量和百分比。
■共90名患者纳入研究。大多数患者因肛门直肠畸形而进行结肠造口术。其中五个具有4倍或更多倍的显着管腔差异。79名患者在2天内达到完全喂养。62例患者术后住院2-3天。6个病人住了5天以上,由于并发症需要进一步处理。我们注意到6例患者的手术部位感染,其中4例患者均采用常规伤口敷料和粪便瘘治疗。其中两个自发解决。
■ERAS协议在结肠造口关闭中减少了住院时间,并且具有成本效益,恢复早,无额外并发症。
UNASSIGNED: To study the safety and feasibility of enhanced recovery after surgery (ERAS) protocol in pediatric colostomy closure.
UNASSIGNED: Retrospective observational study of children who underwent colostomy closure. Data were collected from the electronic medical records and telephonic follow-up calls of patients from October 2013 to October 2023, in the Department of Pediatric Surgery of a Tertiary level Medical College. The parameters obtained were age, gender, type of stoma, primary diagnosis, discrepancy in luminal diameters, time to reach full feeds, postoperative hospital stay, and complications. The protocol followed for colostomy closure included the following-no bowel preparation or nasogastric tube, no overnight fasting, single dose of antibiotic prophylaxis, avoiding opioids, packing proximal stoma till mobilization and starting early oral feeds postoperatively. The continuous parameters were expressed as mean ± standard deviation or median (range) while the descriptive parameters were expressed as number and percentage.
UNASSIGNED: A total of 90 patients were included in the study. Most of the patients had colostomy for anorectal malformation. Five of them had significant luminal discrepancy of 4 or more times. Full feeds were reached within 2 days in 79 patients. Postoperative hospital stay was 2-3 days in 62 patients. Six patients stayed for more than 5 days, due to complications requiring further management. We noted surgical site infection in 6 patients all of whom were managed with regular wound dressings and fecal fistula in 4 cases, two of which resolved spontaneously.
UNASSIGNED: ERAS protocol in colostomy closure reduces the hospital stay and is cost effective, with early recovery and no added complications.