We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on pa...We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.展开更多
BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and...BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.展开更多
1.The development history of enhanced recovery after surgery(ERAS)Enhanced recovery after surgery(ERAS)is a multimodal perioperative care approach that has evolved over the past 2 decades since its inception.In 1997,P...1.The development history of enhanced recovery after surgery(ERAS)Enhanced recovery after surgery(ERAS)is a multimodal perioperative care approach that has evolved over the past 2 decades since its inception.In 1997,Professor Henrik Kehlet,also known as the“father of ERAS”,from the University of Copenhagen in Denmark first proposed the ERAS concept and discovered its clinical feasibility and superiority,achieving remarkable results.ERAS was initially applied in colorectal surgery;subsequently,the concept gradually gained popularity and application worldwide.展开更多
BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptom...BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.展开更多
BACKGROUND Enhanced recovery after surgery(ERAS)represents an innovative,protocoldriven perioperative care program designed to optimize patient outcomes.However,its application and efficacy in infants and children wit...BACKGROUND Enhanced recovery after surgery(ERAS)represents an innovative,protocoldriven perioperative care program designed to optimize patient outcomes.However,its application and efficacy in infants and children with Hirschsprung disease(HD)remain underexplored.AIM To delve into the impact of ERAS on perioperative recovery and the overall medical experience in HD infants and children.METHODS Thirty-eight infants and children with HD who received the Soave surgical procedure were enrolled in this case-control study.According to age-and sexstratified single-blind randomized tables,20 cases received ERAS treatment(ERAS group)and 18 cases received conventional treatment(control group).The two treatments were then compared in terms of perioperative recovery and medical experience.RESULTS Significant differences were observed in pain scores at awakening(4.2±1.3 vs 5.2±1.2,t=2.516,P=0.017)and pain duration(85.69±7.46 hours vs 67.00±8.56 hours,t=7.139,P<0.001)between the ERAS and control group.The recovery of bowel movement was earlier in the ERAS group than in the control group(borborygmus time:33.63±9.83 hours vs 44.69±16.85 hours,t=2.501,P=0.017;feeding time:36.63±9.55 hours vs 49.36±16.99 hours,t=2.884,P=0.007;anal catheter indwelling time:75.83±13.80 hours vs 93.36±20.65 hours,t=3.104,P=0.004),and fever duration(40.73±14.42 hours vs 52.63±18.69 hours,t=2.211,P=0.034).In the ERAS group,hospital stay was shorter(7.5±0.9 days vs 8.3±1.2 days)and the cost was lower(14203±2381 yuan vs 16847±3558 yuan).During the 1-month follow-up period,of the multiple postoperative complications observed,the occurrence of perianal dermatitis(PFisher=0.016)and defecation dysfunction(PFisher=0.027)were lower in the ERAS group than in the control group.CONCLUSION The ERAS protocol has the potential to profoundly enhance postoperative recovery and significantly elevate the overall comfort and quality of the medical experience,making it an indispensable approach that warrants widespread adoption.Continuous refinement through evidence-based practices is anticipated to further optimize its efficacy.展开更多
This review explores the integration of complexity science-specifically,the biological holographic phenomenon and chaosfractal theory-with the fundamental principles of traditional Chinese medicine(TCM)to optimize per...This review explores the integration of complexity science-specifically,the biological holographic phenomenon and chaosfractal theory-with the fundamental principles of traditional Chinese medicine(TCM)to optimize perioperative recovery.It examines how these theories provide a scientific foundation for developing a digital TCM diagnosis and treatment platform.Key topics discussed include the application of digital four-diagnosis technology,visualization of perioperative Yin-Yang states,and artificial intelligence-driven biomarker discovery.By quantifying and digitizing core TCM concepts,this approach enables their incorporation into Enhanced Recovery After Surgery protocols.Ultimately,the review highlights the potential of integrating TCM with Western medicine to advance personalized postoperative management,offering both theoretical insights and practical strategies for improving perioperative care.展开更多
BACKGROUND Enhanced recovery after surgery(ERAS)programs provide recommendations for an optimized management of patients undergoing surgery.An ERAS program tailored on surgery for retroperitoneal sarcomas(RPS)may impr...BACKGROUND Enhanced recovery after surgery(ERAS)programs provide recommendations for an optimized management of patients undergoing surgery.An ERAS program tailored on surgery for retroperitoneal sarcomas(RPS)may improve patient outcomes and it has still not been established.AIM To determine how an ERAS program tailored to RPS surgery can be agreed upon,structured,and implemented.METHODS Twenty-five candidate items from existing ERAS programs,potentially relevant for RPS surgery,were identified via literature review and expert input.These were included in a questionnaire refined through cognitive interviews and pilot testing.Expert sarcoma surgeons rated each item’s relevance and feasibility on a 6-point scale.The survey was recirculated after one year.Intra-observer reproducibility,inter-observer concordance,and agreement with the modal value of the most experienced participants were analyzed.RESULTS Thirteen sarcoma surgeons from 6 centers participated in the survey.Although surgeons agreed on several items,their overall concordance was low.After recirculating the survey,the intraobserver reproducibility was low.Interestingly,the median concordance with the reference increased for relevance and decreased for feasibility.CONCLUSION Despite interest in ERAS for RPS,surgeon concordance on item relevance and feasibility remains low,underscoring the need for collaborative efforts toward a standardized,consensus-based protocol.展开更多
BACKGROUND Gastric cancer predominantly affects the elderly,who face significant challenges due to high postoperative complications and stress.These challenges include co-morbidities,reduced physiological reserves,and...BACKGROUND Gastric cancer predominantly affects the elderly,who face significant challenges due to high postoperative complications and stress.These challenges include co-morbidities,reduced physiological reserves,and increased risks of infections and delayed healing.Traditional postoperative care often falls short in addressing these issues effectively.Enhanced recovery after surgery(ERAS)principles have revolutionized surgical care by reducing stress and promoting recovery through a holistic approach.ERAS emphasizes preoperative optimization,intraoperative care,and postoperative rehabilitation tailored to patient needs.Despite its recog-nized benefits,the impact of continuity nursing care within the ERAS framework on elderly gastric cancer patients remains underexplored.This study examines the influence of ERAS-based continuity nursing care on postoperative satisfaction,inflammation,stress,and quality of life in elderly patients undergoing gastric cancer resection.AIM To investigate the effects of ERAS-based continuity nursing care on postoperative satisfaction,inflammation,stress,and quality of life in elderly gastric cancer pa-tients.METHODS A retrospective cohort analysis was conducted on 322 elderly patients who under-went gastric cancer resection between January 2020 and January 2022.Patients were assigned to a routine care group(n=156)or an ERAS-control(ERAS-C)group(n=166).Data collected included demographic information,inflammatory and stress markers,satisfaction scores using the patient satisfaction questionnaire-18,and quality of life measured using the European Organi-zation for Research and Treatment of Cancer 22-item quality of life questionnaire specific to gastric cancer.RESULTS The ERAS-C group exhibited significantly lower postoperative interleukin-6 levels than the routine care group(12.97±4.02 pg/mL vs 14.37±3.86 pg/mL;P=0.002).This finding indicates that the ERAS-C group experienced reduced inflammation.The ERAS-C group also had a higher cluster of differentiation(CD)4:CD8 ratio than the routine care group(2.34±0.35 vs 2.13±0.61;P<0.001),suggesting the former’s enhanced immune response.Postoperative stress markers,including norepinephrine,cortisol,and aldosterone,were significantly lower in the ERAS-C group than in the routine care group(P<0.05 for all).Compared with the routine care group,the ERAS-C group showed increased nursing satisfaction scores(80.36±7.24 vs 75.23±7.03;P<0.001)and improved quality of life indicators,such as reduced dysphagia and pain,(P<0.05).The ERAS-C group also experienced fewer complic-ations than the routine care group(5.42%vs 11.54%,P=0.048).CONCLUSION Continuity nursing care within the ERAS framework significantly enhances postoperative outcomes for elderly gastric cancer patients by reducing inflammation,stress,and complications while improving satisfaction and qua-lity of life.展开更多
BACKGROUND Enhanced recovery after surgery(ERAS)protocols have emerged as a promising approach in perioperative care.This study evaluated ERAS's impact on gastrointestinal recovery and microbiota composition follo...BACKGROUND Enhanced recovery after surgery(ERAS)protocols have emerged as a promising approach in perioperative care.This study evaluated ERAS's impact on gastrointestinal recovery and microbiota composition following laparoscopic gastric cancer surgery.AIM To evaluate the impact of ERAS protocols on postoperative gastrointestinal function recovery and intestinal microbiota composition in patients undergoing laparoscopic gastric cancer surgery,and to identify factors associated with improved clinical outcomes and microbial diversity preservation.METHODS We conducted a retrospective analysis of 80 patients who underwent laparoscopic D2 gastrectomy,comparing ERAS(n=40)vs traditional care(n=40).Primary outcomes included postoperative gastrointestinal function recovery and complications.Intestinal microbiota was analyzed using 16S rRNA sequencing at multiple timepoints perioperatively.RESULTS ERAS patients demonstrated faster recovery of bowel function,with earlier return of bowel sounds(16.25±6.41 hours vs 22.3±6.49 hours),first flatus(23.95±6.02 hours vs 28.45±7.12 hours),and defecation(34.95±9.34 hours vs 48.1±15.64 hours),all P<0.05.Complication rates,including antibiotic-associated diarrhea and surgical site infections,were comparable between groups.Microbial diversity indices and probiotic populations showed better preservation in the ERAS group postoperatively(P<0.05),though neither group achieved complete restoration to preoperative levels at one month.CONCLUSION These results support tailoring ERAS protocols to prioritize gut microbiome resilience through early feeding and shortened antibiotic courses,with particular benefits for younger patients.展开更多
BACKGROUND Prolonged recovery following colorectal cancer(CRC)surgery can result in physiological discomfort and psychological stress,underscoring the importance of effective perioperative care to enhance patient outc...BACKGROUND Prolonged recovery following colorectal cancer(CRC)surgery can result in physiological discomfort and psychological stress,underscoring the importance of effective perioperative care to enhance patient outcomes.AIM To evaluate the impact of multidisciplinary collaborative enhanced recovery after surgery(ERAS)nursing on patients undergoing CRC surgery.METHODS This study included 100 patients who underwent CRC surgery between August 2022 and August 2024.Patients were divided into two groups based on the perioperative nursing approach.The control group(n=50)received conventional nursing care,whereas the observation group(n=50)received multidisciplinary collaborative ERAS nursing.Postoperative recovery time,disease perception,pain levels,coping strategies,self-management efficacy,and quality of life were compared between the two groups.RESULTS Compared with the control group,the observation group exhibited significantly shorter times to ambulation,gastrointestinal motility,first meal intake,and hospital stay(P<0.05).No significant differences were observed in pre-nursing indicators between the two groups(P>0.05).After nursing,both groups showed improvements in disease perception scores,self-management efficacy,and quality of life scores,along with reductions in pain levels and coping strategy scores,except for the confrontative and venting dimensions.The observation group demonstrated significantly greater improvements in these scores,with significant intergroup and intragroup differences(P<0.05).CONCLUSION Multidisciplinary collaborative ERAS nursing can facilitate postoperative recovery in patients with CRC,enhance disease cognition,alleviate pain,and encourage active coping,thereby improving self-management efficacy and quality of life.展开更多
BACKGROUND Enhanced recovery after surgery(ERAS),a multidisciplinary and multimodal perioperative care protocol,has been widely used in several surgical fields.However,the effect of this care protocol on liver transpl...BACKGROUND Enhanced recovery after surgery(ERAS),a multidisciplinary and multimodal perioperative care protocol,has been widely used in several surgical fields.However,the effect of this care protocol on liver transplant recipients with endstage liver disease remains unclear.AIM To compare the clinical outcomes of the ERAS protocol and standard care(SC)for liver transplant recipients with end-stage liver disease.METHODS PubMed,Web of Science,Cochrane Library,and EMBASE databases were systematically searched to identify literature reporting the effects of the ERAS protocol on clinical outcomes in patients undergoing liver transplant recipients with endstage liver disease.All articles published to January 1,2025 were searched,followed by data extraction of the included literature and independent quality assessment.Then pooled mean difference(MD)and odds ratio(OR)with a 95%confidence interval(CI)were calculated by either a random-effects or fixed-effects model.RESULTS Overall,eight relevant studies(including two randomized controlled trials,two prospective cohort studies,and four retrospective cohort studies)involving 1220 patients(704 patients in the ERAS group and 516 patients in the SC group).The primary outcomes evaluated included intensive care unit(ICU)stay duration,hospital length of stay,overall complication rates,mortality,and 30-day readmission rates.Our findings showed that ERAS protocols significantly reduced ICU stay duration(MD:-1.21 days,95%CI:-2.08 to-0.34;P=0.006),hospital length of stay(MD:-4.91 days,95%CI:-7.45 to-2.37;P=0.0002),overall complication rates(OR=0.32,95%CI:0.22-0.46;P<0.0001),and mortality(OR=0.57,95%CI:0.33-0.98;P=0.04).However,ERAS was associated with an increased 30-day readmission rate(OR=3.20,95%CI:1.54-6.67;P=0.003).CONCLUSION The current meta-analysis indicated that ERAS protocols can significantly improve short-term clinical outcomes in liver transplant recipients,although the increased readmission rate requires further investigation.Future studies should aim to refine ERAS protocols and explore their long-term efficacy and underlying mechanisms.展开更多
BACKGROUND The enhanced recovery after surgery(ERAS)perioperative management framework has been well-documented to improve surgical outcomes and alleviate financial burdens for patients.Against the backdrop of a rapid...BACKGROUND The enhanced recovery after surgery(ERAS)perioperative management framework has been well-documented to improve surgical outcomes and alleviate financial burdens for patients.Against the backdrop of a rapidly aging global population,the incidence of gastric cancer(GC)among elderly individuals continues to increase.AIM To validate the feasibility and safety of the ERAS protocol in elderly GC patients,thereby enhancing its evidence-based medical foundation.METHODS A retrospective analysis of 161 GC patients who underwent ERAS between January 2022 and January 2024 was conducted.The subjects included 79 young patients(<65 years)and 82 elderly patients(≥65 years).The rates of ERAS compliance,postoperative ventilation time,postoperative hospital stay,reoperation rate,mortality rate,postoperative inflammatory markers C-reactive protein(CRP),white blood cells(WBCs),IL-2,IL-6,and the rate of postoperative complications(anastomotic leakage,incision infection,pulmonary infection)were compared between these two groups.RESULTS The incidence of complications in the elderly group was significantly higher than that in the young group,and included hypertension(P=0.002),diabetes(P=0.005),respiratory disease(P=0.034),and heart disease(P=0.016).In terms of American Society of Anesthesiologists(ASA)grading indicators,the overall ASA grade in the elderly group was biased toward grade II,which was significantly higher than that in the young group(P<0.001).There was no significant difference in sex,body mass index,preoperative albumin,preoperative WBCs,TNM classification,differentiation,number of lymph node metastasis,and preoperative IL-6 between the two groups.There were no significant differences between the two groups in terms of operative method,surgical approach,conversion to open surgery,operation time,intraoperative bleeding volume,and number of lymph nodes dissected(all P values>0.05).There were no significant differences between the two groups in ERAS completion rate,reoperation,postoperative first ventilation time,postoperative hospital stays,postoperative anastomotic leakage,postoperative incision infection,postoperative pulmonary infection,and serum inflammatory markers(WBCs,CRP and IL-6)on postoperative day 1 and 3(all P values>0.05).No patients in either group died within 30 days after surgery.CONCLUSION The application of ERAS protocols in elderly patients is feasible and safe,and its management measures are universally applicable to patients of different ages.展开更多
BACKGROUND Gastrointestinal surgery has disadvantages such as long operation time,extended hospitalization time,and slow postoperative recovery.However,the promotion and clinical application of the enhanced recovery a...BACKGROUND Gastrointestinal surgery has disadvantages such as long operation time,extended hospitalization time,and slow postoperative recovery.However,the promotion and clinical application of the enhanced recovery after surgery(ERAS)concept have considerably shortened the hospitalization time of gastrointestinal surgery patients and reduced reactions to surgical stress and the risk of medical complications and readmission.ERAS breaks the conventional operating mode in the field of surgery but introduces great challenges in practice.AIM To explore the application of ERAS in perioperative patients within the field of gastrointestinal surgery,with a particular focus on investigating the awareness of ERAS among healthcare professionals and the barriers to its implementation.METHODS A retrospective study of medical records of perioperative patients in the gastrointestinal surgery ward of Ningbo No.2 Hospital from March 2020 to March 2022 was conducted.According to the different nursing modes adopted by patients during the perioperative period,patients were divided into the ERAS group and the control group.The postoperative outcomes of these groups such as the time to first ambulation,the time to first intake of food,and nursing satisfaction were compared.A self-developed questionnaire was used to assess the awareness of ERAS among healthcare professionals,along with a survey identifying barriers to its implementation.RESULTS Compared with the control group,the ERAS group demonstrated superior scores across various metrics,with the exception of the readmission rate due to complications within 1 month post-discharge(P<0.05).Statistically significant differences were observed between the two groups in terms of educational background,years of service,and prior training in ERAS(P<0.05).CONCLUSION ERAS significantly reduces the time to first ambulation and first food intake for patients undergoing gastrointestinal surgery.Furthermore,the awareness of ERAS among healthcare professionals correlates with their educational background,years of experience,and prior training.ERAS plays a crucial role in expediting patient recovery,improving nursing satisfaction,and optimizing healthcare resources.展开更多
BACKGROUND Enhanced recovery after surgery(ERAS)guidelines have been established for multiple types of adult surgeries.However,ERAS guidelines tailored to pediatric surgeries remain to be developed.AIM To evaluate the...BACKGROUND Enhanced recovery after surgery(ERAS)guidelines have been established for multiple types of adult surgeries.However,ERAS guidelines tailored to pediatric surgeries remain to be developed.AIM To evaluate the clinical outcomes of ERAS protocols in pediatric laparoscopic Meckel’s diverticulum resection.METHODS This retrospective cohort study analyzed 78 consecutive pediatric cases treated between January 2017 and March 2025.Patients were divided into:Traditional care group(n=38):January 2017-December 2020;ERAS protocol group(n=40):January 2021-March 2025.We compared perioperative outcomes,including clinical recovery parameters and laboratory markers,to assess protocol efficacy.RESULTS All procedures were completed laparoscopically by the same surgical team without conversion.Baseline characteristics,including demographics,diverticulum location,and intraoperative parameters(operative time,blood loss),were comparable between groups(all P>0.05).The ERAS protocol demonstrated significantly shorter postoperative length of stay(7.55±1.52 days vs 10.40±3.59 days,P<0.001)while complication rates were numerically lower in the ERAS group(17.50%vs 13.16%,P=0.595).Additional benefits of ERAS implementation included:Reduced intravenous fluid requirements(5.00 mL/kg/hour vs 8.00 mL/kg/hour),accelerated gastrointestinal recovery(first flatus:2.00 days vs 3.00 days),lower pain scores(P<0.001),earlier total enteral nutrition achievement(5.00 days vs 6.50 days)and shorter intravenous therapy duration(6.00 days vs 8.00 days;all P<0.001).ERAS patients also showed reduced drainage utilization(P<0.05)and improved inflammatory marker profiles postoperatively[neutrophils:(5.98±2.02)×10^(9)/L vs(8.01±3.98)×10^(9)/L];median Creactive protein:13.6 mg/L 7 vs 19.63 mg/L).Glycemic control was superior in the ERAS group despite higher induction levels(both P<0.05).Parental satisfaction(92.50%vs 86.84%)and 30-day readmission rates(2.50%vs 2.63%)showed no significant differences.CONCLUSION ERAS protocols safely optimize recovery in children undergoing laparoscopic Meckel’s diverticulum resection,significantly reducing length of stay while improving pain management and overall clinical outcomes.These findings support the adoption of ERAS in pediatric intestinal surgery.展开更多
BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)...BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)as a new nursing model postsurgery remains uncertain.AIM To investigate the clinical effect of accelerated recovery nursing program based on multidisciplinary collaboration model in gastric cancer surgery.METHODS A total of 120 patients who underwent radical gastrectomy at our hospital from January 2023 to December 2024 were included in the study.They were divided into two groups of 60 each:The control group,which received routine care,and the study group,which received ERAS based on multidisciplinary collaboration.Both groups received care until discharge.We compared gastrointestinal recovery,psychological status,Short Form 36 Health Survey scores,Pittsburgh Sleep Quality Index,complications,and nursing satisfaction between the two groups.RESULTS The study group had significantly shorter defecation time,bowel sound recovery time,and flatus time compared to the control group(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Rating Scale scores were also significantly lower in the study group(P<0.05).Additionally,the study group reported better sleep quality(P<0.05)and had fewer postoperative complications.Their Short Form 36 Health Survey scores and nursing satisfaction were higher than those of the control group,with all differences being statistically significant(P<0.05).CONCLUSION The ERAS based on multidisciplinary collaboration in patients undergoing radical gastrectomy can accelerate postoperative recovery,reduce the occurrence of complications,and improve psychological state,quality of life,sleep quality and nursing satisfaction.展开更多
Gastric cancer with peritoneal carcinomatosis(PC)remains a formidable challenge in oncological care,especially regarding surgical intervention.Integrating enhanced recovery after surgery(ERAS)protocols into gastrectom...Gastric cancer with peritoneal carcinomatosis(PC)remains a formidable challenge in oncological care,especially regarding surgical intervention.Integrating enhanced recovery after surgery(ERAS)protocols into gastrectomy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy has emerged as a promising approach.This minireview explores the influence of ERAS on surgical and oncological outcomes in this multifaceted procedure.Recent evidence suggests that ERAS,comprising multimodal strategies,improves postoperative recovery,reduces complications,and enhances quality of life.It may also contribute to better survival outcomes by minimizing perioperative morbidity and thereby facilitating the timely initiation of adjuvant therapy.Mechanistically,ERAS promotes early mobilization,attenuates postoperative immunosuppression,and supports timely adjuvant therapies,which are crucial in managing carcinomatosis.This minireview underscores the importance of multidisciplinary collaboration and individualized patient care to maximize ERAS benefits.Large-scale,prospective investigations are warranted to validate these findings and refine ERAS protocols for this specialized patient cohort.Further research will facilitate ongoing advancements in oncological surgery and perioperative care,ultimately improving outcomes for patients with gastric cancer and PC.展开更多
BACKGROUND Laparoscopic cholecystectomy is the primary method for treating cholecystitis.Traditional postoperative care has poor outcomes for patient recovery.The enhanced recovery after surgery(ERAS)model is increasi...BACKGROUND Laparoscopic cholecystectomy is the primary method for treating cholecystitis.Traditional postoperative care has poor outcomes for patient recovery.The enhanced recovery after surgery(ERAS)model is increasingly applied in clinical settings.However,the impact of this nursing model on patients undergoing laparoscopic cholecystectomy remains unclear.AIM To evaluate the effects of ERAS on postoperative gastrointestinal recovery and quality of life in patients undergoing laparoscopic cholecystectomy.METHODS This is a retrospective study design in which we collected clinical data from 120 patients who underwent laparoscopic cholecystectomy at our hospital.Patients were divided into a control group(n=60)and a study group(n=60)based on the type of nursing intervention.The control group received conventional care,while the study group received ERAS.We assessed gastrointestinal recovery,quality of life,and nursing satisfaction before and after the nursing interventions in both groups.RESULTS After nursing care,the gastrointestinal recovery times(time to bowel sounds return,time to flatus,time to first bowel movement,and time to first meal)in the study group were significantly shorter than those in the control group,with statistically significant differences between the two groups(P<0.05).Additionally,the quality of life in the study group was significantly higher than that in the control group(P<0.05).The nursing satisfaction in the study group was also significantly higher than that in the control group,with statistically significant differences between the two groups(P<0.05).CONCLUSION In summary,compared to conventional nursing,ERAS can more rapidly promote gastrointestinal recovery and improve the quality of life in patients after laparoscopic cholecystectomy.Further clinical application of this approach is warranted.展开更多
BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the imp...BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.展开更多
BACKGROUND Traditional postoperative nursing methods implemented after laparoscopic hepatectomy often leads to slow patient recovery.As a new nursing mode,enhanced recovery after surgery(ERAS)has been widely used in t...BACKGROUND Traditional postoperative nursing methods implemented after laparoscopic hepatectomy often leads to slow patient recovery.As a new nursing mode,enhanced recovery after surgery(ERAS)has been widely used in the peri-and postoperative care of patients.However,its effects after laparoscopic hepatectomy remains unclear.AIM To explore the influence of nursing under the ERAS concept on time to first ambulation and complications after laparoscopic hepatectomy.METHODS Data from 119 patients,who underwent laparoscopic hepatectomy for various indications between January 2020 and March 2025,were divided into 2 groups according to nursing mode:Observation[nursing based on the ERAS concept(n=59)],and control[basic nursing(n=60)].Time to first ambulation,complications,length of hospital stay,and numerical rating scale(NRS)scores were compared between the groups.Statistical analysis was performed using SPSS version 26.0(IBM Corp.,Armonk,NY,United States).Differences with P<0.05 were considered statistically significant.RESULTS Findings indicated that after post-nursing intervention,the observation group experienced significantly sooner initial discharge times and shorter hospital stays than the control group(P<0.05).The NRS score of the observation group was lower than that of the control group(P<0.05).The observation group experienced a significantly lower incidence of postoperative complications than the control group(P<0.05).CONCLUSION Operating room nursing based on the ERAS concept significantly shortens the time to first ambulation,reduces the incidence of postoperative complications,and improves patient quality of life after laparoscopic hepatectomy.展开更多
BACKGROUND Gastrointestinal(GI)perforation(GP)repair is a surgical procedure to promptly seal perforations in the GI tract to prevent further leakage.After surgery,patients often experience a high metabolic state due ...BACKGROUND Gastrointestinal(GI)perforation(GP)repair is a surgical procedure to promptly seal perforations in the GI tract to prevent further leakage.After surgery,patients often experience a high metabolic state due to trauma,infection,and posto-perative stress.In the Enhanced Recovery After Surgery(ERAS)protocol,early enteral nutrition is a key strategy for promoting postoperative recovery.Com-pared with parenteral nutrition,enteral nutrition more effectively meets the physiological needs of the GI system,promotes the recovery of gut function,and reduces the risk of GI infections.AIM To evaluate the clinical efficacy of early enteral nutrition support in patients undergoing GP repair within the ERAS protocol.METHODS This retrospective study analyzed 66 patients who underwent GP repair.Patients were divided into a control group(n=32),managed with a traditional nutritional regimen,primarily consisting of total parenteral nutrition;and an observation group(n=34),which included those who received early enteral nutrition support as part of the ERAS protocol.This study examined the time to first postoperative flatus and bowel movement,changes in nutritional and immune function,inflam-matory markers on postoperative days 1 and 5,and adverse reactions.RESULTS The observation group had significantly shorter times to the first postoperative flatus and bowel movement than the control group(P<0.05).On postoperative day 5,the observation group demonstrated higher nutritional and immune function levels than the control group(P<0.05),while C-reactive protein levels were significantly lower(P<0.05).The overall incidence of adverse reactions in the observation group was 8.82%(3/34),which was lower than the 28.13%(9/32)observed in the control group(P<0.05).CONCLUSION Early enteral nutritional support facilitates GI recovery after GP repair.It improves nutritional status,enhances immune function,and attenuates inflammatory responses while also demonstrating a favorable safety profile.展开更多
文摘We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.
基金Supported by 2025 Henan Medical Education Research Project,No.WJLX2025038.
文摘BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.
文摘1.The development history of enhanced recovery after surgery(ERAS)Enhanced recovery after surgery(ERAS)is a multimodal perioperative care approach that has evolved over the past 2 decades since its inception.In 1997,Professor Henrik Kehlet,also known as the“father of ERAS”,from the University of Copenhagen in Denmark first proposed the ERAS concept and discovered its clinical feasibility and superiority,achieving remarkable results.ERAS was initially applied in colorectal surgery;subsequently,the concept gradually gained popularity and application worldwide.
文摘BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.
基金Supported by the Project of Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,No.2021YJ005the Science&Technology Department of Sichuan Province,China,No.2019YJ0701。
文摘BACKGROUND Enhanced recovery after surgery(ERAS)represents an innovative,protocoldriven perioperative care program designed to optimize patient outcomes.However,its application and efficacy in infants and children with Hirschsprung disease(HD)remain underexplored.AIM To delve into the impact of ERAS on perioperative recovery and the overall medical experience in HD infants and children.METHODS Thirty-eight infants and children with HD who received the Soave surgical procedure were enrolled in this case-control study.According to age-and sexstratified single-blind randomized tables,20 cases received ERAS treatment(ERAS group)and 18 cases received conventional treatment(control group).The two treatments were then compared in terms of perioperative recovery and medical experience.RESULTS Significant differences were observed in pain scores at awakening(4.2±1.3 vs 5.2±1.2,t=2.516,P=0.017)and pain duration(85.69±7.46 hours vs 67.00±8.56 hours,t=7.139,P<0.001)between the ERAS and control group.The recovery of bowel movement was earlier in the ERAS group than in the control group(borborygmus time:33.63±9.83 hours vs 44.69±16.85 hours,t=2.501,P=0.017;feeding time:36.63±9.55 hours vs 49.36±16.99 hours,t=2.884,P=0.007;anal catheter indwelling time:75.83±13.80 hours vs 93.36±20.65 hours,t=3.104,P=0.004),and fever duration(40.73±14.42 hours vs 52.63±18.69 hours,t=2.211,P=0.034).In the ERAS group,hospital stay was shorter(7.5±0.9 days vs 8.3±1.2 days)and the cost was lower(14203±2381 yuan vs 16847±3558 yuan).During the 1-month follow-up period,of the multiple postoperative complications observed,the occurrence of perianal dermatitis(PFisher=0.016)and defecation dysfunction(PFisher=0.027)were lower in the ERAS group than in the control group.CONCLUSION The ERAS protocol has the potential to profoundly enhance postoperative recovery and significantly elevate the overall comfort and quality of the medical experience,making it an indispensable approach that warrants widespread adoption.Continuous refinement through evidence-based practices is anticipated to further optimize its efficacy.
基金China Medical Education Association 2022 Major Scientific Research Topics(Number:2022KTZ005)Jiangsu Province 14th Five-Year Medical Key Discipline:Traditional Chinese Surgery(Number:ZDXK202251).
文摘This review explores the integration of complexity science-specifically,the biological holographic phenomenon and chaosfractal theory-with the fundamental principles of traditional Chinese medicine(TCM)to optimize perioperative recovery.It examines how these theories provide a scientific foundation for developing a digital TCM diagnosis and treatment platform.Key topics discussed include the application of digital four-diagnosis technology,visualization of perioperative Yin-Yang states,and artificial intelligence-driven biomarker discovery.By quantifying and digitizing core TCM concepts,this approach enables their incorporation into Enhanced Recovery After Surgery protocols.Ultimately,the review highlights the potential of integrating TCM with Western medicine to advance personalized postoperative management,offering both theoretical insights and practical strategies for improving perioperative care.
文摘BACKGROUND Enhanced recovery after surgery(ERAS)programs provide recommendations for an optimized management of patients undergoing surgery.An ERAS program tailored on surgery for retroperitoneal sarcomas(RPS)may improve patient outcomes and it has still not been established.AIM To determine how an ERAS program tailored to RPS surgery can be agreed upon,structured,and implemented.METHODS Twenty-five candidate items from existing ERAS programs,potentially relevant for RPS surgery,were identified via literature review and expert input.These were included in a questionnaire refined through cognitive interviews and pilot testing.Expert sarcoma surgeons rated each item’s relevance and feasibility on a 6-point scale.The survey was recirculated after one year.Intra-observer reproducibility,inter-observer concordance,and agreement with the modal value of the most experienced participants were analyzed.RESULTS Thirteen sarcoma surgeons from 6 centers participated in the survey.Although surgeons agreed on several items,their overall concordance was low.After recirculating the survey,the intraobserver reproducibility was low.Interestingly,the median concordance with the reference increased for relevance and decreased for feasibility.CONCLUSION Despite interest in ERAS for RPS,surgeon concordance on item relevance and feasibility remains low,underscoring the need for collaborative efforts toward a standardized,consensus-based protocol.
文摘BACKGROUND Gastric cancer predominantly affects the elderly,who face significant challenges due to high postoperative complications and stress.These challenges include co-morbidities,reduced physiological reserves,and increased risks of infections and delayed healing.Traditional postoperative care often falls short in addressing these issues effectively.Enhanced recovery after surgery(ERAS)principles have revolutionized surgical care by reducing stress and promoting recovery through a holistic approach.ERAS emphasizes preoperative optimization,intraoperative care,and postoperative rehabilitation tailored to patient needs.Despite its recog-nized benefits,the impact of continuity nursing care within the ERAS framework on elderly gastric cancer patients remains underexplored.This study examines the influence of ERAS-based continuity nursing care on postoperative satisfaction,inflammation,stress,and quality of life in elderly patients undergoing gastric cancer resection.AIM To investigate the effects of ERAS-based continuity nursing care on postoperative satisfaction,inflammation,stress,and quality of life in elderly gastric cancer pa-tients.METHODS A retrospective cohort analysis was conducted on 322 elderly patients who under-went gastric cancer resection between January 2020 and January 2022.Patients were assigned to a routine care group(n=156)or an ERAS-control(ERAS-C)group(n=166).Data collected included demographic information,inflammatory and stress markers,satisfaction scores using the patient satisfaction questionnaire-18,and quality of life measured using the European Organi-zation for Research and Treatment of Cancer 22-item quality of life questionnaire specific to gastric cancer.RESULTS The ERAS-C group exhibited significantly lower postoperative interleukin-6 levels than the routine care group(12.97±4.02 pg/mL vs 14.37±3.86 pg/mL;P=0.002).This finding indicates that the ERAS-C group experienced reduced inflammation.The ERAS-C group also had a higher cluster of differentiation(CD)4:CD8 ratio than the routine care group(2.34±0.35 vs 2.13±0.61;P<0.001),suggesting the former’s enhanced immune response.Postoperative stress markers,including norepinephrine,cortisol,and aldosterone,were significantly lower in the ERAS-C group than in the routine care group(P<0.05 for all).Compared with the routine care group,the ERAS-C group showed increased nursing satisfaction scores(80.36±7.24 vs 75.23±7.03;P<0.001)and improved quality of life indicators,such as reduced dysphagia and pain,(P<0.05).The ERAS-C group also experienced fewer complic-ations than the routine care group(5.42%vs 11.54%,P=0.048).CONCLUSION Continuity nursing care within the ERAS framework significantly enhances postoperative outcomes for elderly gastric cancer patients by reducing inflammation,stress,and complications while improving satisfaction and qua-lity of life.
基金Supported by the Zhejiang Provincial Science and Technology Project for Traditional Chinese Medicine,No.2024ZL345.
文摘BACKGROUND Enhanced recovery after surgery(ERAS)protocols have emerged as a promising approach in perioperative care.This study evaluated ERAS's impact on gastrointestinal recovery and microbiota composition following laparoscopic gastric cancer surgery.AIM To evaluate the impact of ERAS protocols on postoperative gastrointestinal function recovery and intestinal microbiota composition in patients undergoing laparoscopic gastric cancer surgery,and to identify factors associated with improved clinical outcomes and microbial diversity preservation.METHODS We conducted a retrospective analysis of 80 patients who underwent laparoscopic D2 gastrectomy,comparing ERAS(n=40)vs traditional care(n=40).Primary outcomes included postoperative gastrointestinal function recovery and complications.Intestinal microbiota was analyzed using 16S rRNA sequencing at multiple timepoints perioperatively.RESULTS ERAS patients demonstrated faster recovery of bowel function,with earlier return of bowel sounds(16.25±6.41 hours vs 22.3±6.49 hours),first flatus(23.95±6.02 hours vs 28.45±7.12 hours),and defecation(34.95±9.34 hours vs 48.1±15.64 hours),all P<0.05.Complication rates,including antibiotic-associated diarrhea and surgical site infections,were comparable between groups.Microbial diversity indices and probiotic populations showed better preservation in the ERAS group postoperatively(P<0.05),though neither group achieved complete restoration to preoperative levels at one month.CONCLUSION These results support tailoring ERAS protocols to prioritize gut microbiome resilience through early feeding and shortened antibiotic courses,with particular benefits for younger patients.
文摘BACKGROUND Prolonged recovery following colorectal cancer(CRC)surgery can result in physiological discomfort and psychological stress,underscoring the importance of effective perioperative care to enhance patient outcomes.AIM To evaluate the impact of multidisciplinary collaborative enhanced recovery after surgery(ERAS)nursing on patients undergoing CRC surgery.METHODS This study included 100 patients who underwent CRC surgery between August 2022 and August 2024.Patients were divided into two groups based on the perioperative nursing approach.The control group(n=50)received conventional nursing care,whereas the observation group(n=50)received multidisciplinary collaborative ERAS nursing.Postoperative recovery time,disease perception,pain levels,coping strategies,self-management efficacy,and quality of life were compared between the two groups.RESULTS Compared with the control group,the observation group exhibited significantly shorter times to ambulation,gastrointestinal motility,first meal intake,and hospital stay(P<0.05).No significant differences were observed in pre-nursing indicators between the two groups(P>0.05).After nursing,both groups showed improvements in disease perception scores,self-management efficacy,and quality of life scores,along with reductions in pain levels and coping strategy scores,except for the confrontative and venting dimensions.The observation group demonstrated significantly greater improvements in these scores,with significant intergroup and intragroup differences(P<0.05).CONCLUSION Multidisciplinary collaborative ERAS nursing can facilitate postoperative recovery in patients with CRC,enhance disease cognition,alleviate pain,and encourage active coping,thereby improving self-management efficacy and quality of life.
文摘BACKGROUND Enhanced recovery after surgery(ERAS),a multidisciplinary and multimodal perioperative care protocol,has been widely used in several surgical fields.However,the effect of this care protocol on liver transplant recipients with endstage liver disease remains unclear.AIM To compare the clinical outcomes of the ERAS protocol and standard care(SC)for liver transplant recipients with end-stage liver disease.METHODS PubMed,Web of Science,Cochrane Library,and EMBASE databases were systematically searched to identify literature reporting the effects of the ERAS protocol on clinical outcomes in patients undergoing liver transplant recipients with endstage liver disease.All articles published to January 1,2025 were searched,followed by data extraction of the included literature and independent quality assessment.Then pooled mean difference(MD)and odds ratio(OR)with a 95%confidence interval(CI)were calculated by either a random-effects or fixed-effects model.RESULTS Overall,eight relevant studies(including two randomized controlled trials,two prospective cohort studies,and four retrospective cohort studies)involving 1220 patients(704 patients in the ERAS group and 516 patients in the SC group).The primary outcomes evaluated included intensive care unit(ICU)stay duration,hospital length of stay,overall complication rates,mortality,and 30-day readmission rates.Our findings showed that ERAS protocols significantly reduced ICU stay duration(MD:-1.21 days,95%CI:-2.08 to-0.34;P=0.006),hospital length of stay(MD:-4.91 days,95%CI:-7.45 to-2.37;P=0.0002),overall complication rates(OR=0.32,95%CI:0.22-0.46;P<0.0001),and mortality(OR=0.57,95%CI:0.33-0.98;P=0.04).However,ERAS was associated with an increased 30-day readmission rate(OR=3.20,95%CI:1.54-6.67;P=0.003).CONCLUSION The current meta-analysis indicated that ERAS protocols can significantly improve short-term clinical outcomes in liver transplant recipients,although the increased readmission rate requires further investigation.Future studies should aim to refine ERAS protocols and explore their long-term efficacy and underlying mechanisms.
基金Supported by The Medical Key Discipline Construction Project of Jiangsu Province,No.ZDXK202251The Key project of Jiangsu Provincial Hospital Administration of Traditional Chinese Medicine,No.ZD201903+1 种基金The Project of China Medical Education Association,No.2022KTZ005National Natural Science Foundation of China,No.81500417.
文摘BACKGROUND The enhanced recovery after surgery(ERAS)perioperative management framework has been well-documented to improve surgical outcomes and alleviate financial burdens for patients.Against the backdrop of a rapidly aging global population,the incidence of gastric cancer(GC)among elderly individuals continues to increase.AIM To validate the feasibility and safety of the ERAS protocol in elderly GC patients,thereby enhancing its evidence-based medical foundation.METHODS A retrospective analysis of 161 GC patients who underwent ERAS between January 2022 and January 2024 was conducted.The subjects included 79 young patients(<65 years)and 82 elderly patients(≥65 years).The rates of ERAS compliance,postoperative ventilation time,postoperative hospital stay,reoperation rate,mortality rate,postoperative inflammatory markers C-reactive protein(CRP),white blood cells(WBCs),IL-2,IL-6,and the rate of postoperative complications(anastomotic leakage,incision infection,pulmonary infection)were compared between these two groups.RESULTS The incidence of complications in the elderly group was significantly higher than that in the young group,and included hypertension(P=0.002),diabetes(P=0.005),respiratory disease(P=0.034),and heart disease(P=0.016).In terms of American Society of Anesthesiologists(ASA)grading indicators,the overall ASA grade in the elderly group was biased toward grade II,which was significantly higher than that in the young group(P<0.001).There was no significant difference in sex,body mass index,preoperative albumin,preoperative WBCs,TNM classification,differentiation,number of lymph node metastasis,and preoperative IL-6 between the two groups.There were no significant differences between the two groups in terms of operative method,surgical approach,conversion to open surgery,operation time,intraoperative bleeding volume,and number of lymph nodes dissected(all P values>0.05).There were no significant differences between the two groups in ERAS completion rate,reoperation,postoperative first ventilation time,postoperative hospital stays,postoperative anastomotic leakage,postoperative incision infection,postoperative pulmonary infection,and serum inflammatory markers(WBCs,CRP and IL-6)on postoperative day 1 and 3(all P values>0.05).No patients in either group died within 30 days after surgery.CONCLUSION The application of ERAS protocols in elderly patients is feasible and safe,and its management measures are universally applicable to patients of different ages.
基金Supported by Zhejiang Province Medical and Health Science and Technology Project,No.2025KY1381。
文摘BACKGROUND Gastrointestinal surgery has disadvantages such as long operation time,extended hospitalization time,and slow postoperative recovery.However,the promotion and clinical application of the enhanced recovery after surgery(ERAS)concept have considerably shortened the hospitalization time of gastrointestinal surgery patients and reduced reactions to surgical stress and the risk of medical complications and readmission.ERAS breaks the conventional operating mode in the field of surgery but introduces great challenges in practice.AIM To explore the application of ERAS in perioperative patients within the field of gastrointestinal surgery,with a particular focus on investigating the awareness of ERAS among healthcare professionals and the barriers to its implementation.METHODS A retrospective study of medical records of perioperative patients in the gastrointestinal surgery ward of Ningbo No.2 Hospital from March 2020 to March 2022 was conducted.According to the different nursing modes adopted by patients during the perioperative period,patients were divided into the ERAS group and the control group.The postoperative outcomes of these groups such as the time to first ambulation,the time to first intake of food,and nursing satisfaction were compared.A self-developed questionnaire was used to assess the awareness of ERAS among healthcare professionals,along with a survey identifying barriers to its implementation.RESULTS Compared with the control group,the ERAS group demonstrated superior scores across various metrics,with the exception of the readmission rate due to complications within 1 month post-discharge(P<0.05).Statistically significant differences were observed between the two groups in terms of educational background,years of service,and prior training in ERAS(P<0.05).CONCLUSION ERAS significantly reduces the time to first ambulation and first food intake for patients undergoing gastrointestinal surgery.Furthermore,the awareness of ERAS among healthcare professionals correlates with their educational background,years of experience,and prior training.ERAS plays a crucial role in expediting patient recovery,improving nursing satisfaction,and optimizing healthcare resources.
文摘BACKGROUND Enhanced recovery after surgery(ERAS)guidelines have been established for multiple types of adult surgeries.However,ERAS guidelines tailored to pediatric surgeries remain to be developed.AIM To evaluate the clinical outcomes of ERAS protocols in pediatric laparoscopic Meckel’s diverticulum resection.METHODS This retrospective cohort study analyzed 78 consecutive pediatric cases treated between January 2017 and March 2025.Patients were divided into:Traditional care group(n=38):January 2017-December 2020;ERAS protocol group(n=40):January 2021-March 2025.We compared perioperative outcomes,including clinical recovery parameters and laboratory markers,to assess protocol efficacy.RESULTS All procedures were completed laparoscopically by the same surgical team without conversion.Baseline characteristics,including demographics,diverticulum location,and intraoperative parameters(operative time,blood loss),were comparable between groups(all P>0.05).The ERAS protocol demonstrated significantly shorter postoperative length of stay(7.55±1.52 days vs 10.40±3.59 days,P<0.001)while complication rates were numerically lower in the ERAS group(17.50%vs 13.16%,P=0.595).Additional benefits of ERAS implementation included:Reduced intravenous fluid requirements(5.00 mL/kg/hour vs 8.00 mL/kg/hour),accelerated gastrointestinal recovery(first flatus:2.00 days vs 3.00 days),lower pain scores(P<0.001),earlier total enteral nutrition achievement(5.00 days vs 6.50 days)and shorter intravenous therapy duration(6.00 days vs 8.00 days;all P<0.001).ERAS patients also showed reduced drainage utilization(P<0.05)and improved inflammatory marker profiles postoperatively[neutrophils:(5.98±2.02)×10^(9)/L vs(8.01±3.98)×10^(9)/L];median Creactive protein:13.6 mg/L 7 vs 19.63 mg/L).Glycemic control was superior in the ERAS group despite higher induction levels(both P<0.05).Parental satisfaction(92.50%vs 86.84%)and 30-day readmission rates(2.50%vs 2.63%)showed no significant differences.CONCLUSION ERAS protocols safely optimize recovery in children undergoing laparoscopic Meckel’s diverticulum resection,significantly reducing length of stay while improving pain management and overall clinical outcomes.These findings support the adoption of ERAS in pediatric intestinal surgery.
文摘BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)as a new nursing model postsurgery remains uncertain.AIM To investigate the clinical effect of accelerated recovery nursing program based on multidisciplinary collaboration model in gastric cancer surgery.METHODS A total of 120 patients who underwent radical gastrectomy at our hospital from January 2023 to December 2024 were included in the study.They were divided into two groups of 60 each:The control group,which received routine care,and the study group,which received ERAS based on multidisciplinary collaboration.Both groups received care until discharge.We compared gastrointestinal recovery,psychological status,Short Form 36 Health Survey scores,Pittsburgh Sleep Quality Index,complications,and nursing satisfaction between the two groups.RESULTS The study group had significantly shorter defecation time,bowel sound recovery time,and flatus time compared to the control group(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Rating Scale scores were also significantly lower in the study group(P<0.05).Additionally,the study group reported better sleep quality(P<0.05)and had fewer postoperative complications.Their Short Form 36 Health Survey scores and nursing satisfaction were higher than those of the control group,with all differences being statistically significant(P<0.05).CONCLUSION The ERAS based on multidisciplinary collaboration in patients undergoing radical gastrectomy can accelerate postoperative recovery,reduce the occurrence of complications,and improve psychological state,quality of life,sleep quality and nursing satisfaction.
文摘Gastric cancer with peritoneal carcinomatosis(PC)remains a formidable challenge in oncological care,especially regarding surgical intervention.Integrating enhanced recovery after surgery(ERAS)protocols into gastrectomy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy has emerged as a promising approach.This minireview explores the influence of ERAS on surgical and oncological outcomes in this multifaceted procedure.Recent evidence suggests that ERAS,comprising multimodal strategies,improves postoperative recovery,reduces complications,and enhances quality of life.It may also contribute to better survival outcomes by minimizing perioperative morbidity and thereby facilitating the timely initiation of adjuvant therapy.Mechanistically,ERAS promotes early mobilization,attenuates postoperative immunosuppression,and supports timely adjuvant therapies,which are crucial in managing carcinomatosis.This minireview underscores the importance of multidisciplinary collaboration and individualized patient care to maximize ERAS benefits.Large-scale,prospective investigations are warranted to validate these findings and refine ERAS protocols for this specialized patient cohort.Further research will facilitate ongoing advancements in oncological surgery and perioperative care,ultimately improving outcomes for patients with gastric cancer and PC.
文摘BACKGROUND Laparoscopic cholecystectomy is the primary method for treating cholecystitis.Traditional postoperative care has poor outcomes for patient recovery.The enhanced recovery after surgery(ERAS)model is increasingly applied in clinical settings.However,the impact of this nursing model on patients undergoing laparoscopic cholecystectomy remains unclear.AIM To evaluate the effects of ERAS on postoperative gastrointestinal recovery and quality of life in patients undergoing laparoscopic cholecystectomy.METHODS This is a retrospective study design in which we collected clinical data from 120 patients who underwent laparoscopic cholecystectomy at our hospital.Patients were divided into a control group(n=60)and a study group(n=60)based on the type of nursing intervention.The control group received conventional care,while the study group received ERAS.We assessed gastrointestinal recovery,quality of life,and nursing satisfaction before and after the nursing interventions in both groups.RESULTS After nursing care,the gastrointestinal recovery times(time to bowel sounds return,time to flatus,time to first bowel movement,and time to first meal)in the study group were significantly shorter than those in the control group,with statistically significant differences between the two groups(P<0.05).Additionally,the quality of life in the study group was significantly higher than that in the control group(P<0.05).The nursing satisfaction in the study group was also significantly higher than that in the control group,with statistically significant differences between the two groups(P<0.05).CONCLUSION In summary,compared to conventional nursing,ERAS can more rapidly promote gastrointestinal recovery and improve the quality of life in patients after laparoscopic cholecystectomy.Further clinical application of this approach is warranted.
文摘BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.
文摘BACKGROUND Traditional postoperative nursing methods implemented after laparoscopic hepatectomy often leads to slow patient recovery.As a new nursing mode,enhanced recovery after surgery(ERAS)has been widely used in the peri-and postoperative care of patients.However,its effects after laparoscopic hepatectomy remains unclear.AIM To explore the influence of nursing under the ERAS concept on time to first ambulation and complications after laparoscopic hepatectomy.METHODS Data from 119 patients,who underwent laparoscopic hepatectomy for various indications between January 2020 and March 2025,were divided into 2 groups according to nursing mode:Observation[nursing based on the ERAS concept(n=59)],and control[basic nursing(n=60)].Time to first ambulation,complications,length of hospital stay,and numerical rating scale(NRS)scores were compared between the groups.Statistical analysis was performed using SPSS version 26.0(IBM Corp.,Armonk,NY,United States).Differences with P<0.05 were considered statistically significant.RESULTS Findings indicated that after post-nursing intervention,the observation group experienced significantly sooner initial discharge times and shorter hospital stays than the control group(P<0.05).The NRS score of the observation group was lower than that of the control group(P<0.05).The observation group experienced a significantly lower incidence of postoperative complications than the control group(P<0.05).CONCLUSION Operating room nursing based on the ERAS concept significantly shortens the time to first ambulation,reduces the incidence of postoperative complications,and improves patient quality of life after laparoscopic hepatectomy.
文摘BACKGROUND Gastrointestinal(GI)perforation(GP)repair is a surgical procedure to promptly seal perforations in the GI tract to prevent further leakage.After surgery,patients often experience a high metabolic state due to trauma,infection,and posto-perative stress.In the Enhanced Recovery After Surgery(ERAS)protocol,early enteral nutrition is a key strategy for promoting postoperative recovery.Com-pared with parenteral nutrition,enteral nutrition more effectively meets the physiological needs of the GI system,promotes the recovery of gut function,and reduces the risk of GI infections.AIM To evaluate the clinical efficacy of early enteral nutrition support in patients undergoing GP repair within the ERAS protocol.METHODS This retrospective study analyzed 66 patients who underwent GP repair.Patients were divided into a control group(n=32),managed with a traditional nutritional regimen,primarily consisting of total parenteral nutrition;and an observation group(n=34),which included those who received early enteral nutrition support as part of the ERAS protocol.This study examined the time to first postoperative flatus and bowel movement,changes in nutritional and immune function,inflam-matory markers on postoperative days 1 and 5,and adverse reactions.RESULTS The observation group had significantly shorter times to the first postoperative flatus and bowel movement than the control group(P<0.05).On postoperative day 5,the observation group demonstrated higher nutritional and immune function levels than the control group(P<0.05),while C-reactive protein levels were significantly lower(P<0.05).The overall incidence of adverse reactions in the observation group was 8.82%(3/34),which was lower than the 28.13%(9/32)observed in the control group(P<0.05).CONCLUSION Early enteral nutritional support facilitates GI recovery after GP repair.It improves nutritional status,enhances immune function,and attenuates inflammatory responses while also demonstrating a favorable safety profile.
