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遵循减瘤手术及腹腔热灌注化疗治疗腹膜癌病手术方案后的加速康复评估

Evaluation of Enhanced Recovery After Following a Surgical Protocol for Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis.

作者信息

Duzgun Ozgul

机构信息

Department of Surgical Oncology, Health Sciences University, Umraniye Training and Research Hospital, Umraniye/Istanbul, Turkey.

出版信息

Med Arch. 2019 Oct;73(5):331-337. doi: 10.5455/medarh.2019.73.331-337.

Abstract

INTRODUCTION

Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy (CRS ± HIPEC) has positive effects on the survival of patients with peritoneal carcinomatosis (PC) due to intra-abdominal tumors. Currently, the available literature on the safety of the Enhanced Recovery After Surgery (ERAS) protocol for PC, which is associated with severe morbidity and mortality, is insufficient.

AIM

This study aimed to present our results from treating patients using the ERAS protocol for PC that developed due to intra-abdominal tumors.

MATERIAL AND METHODS

The data of 120 consecutive patients with PC due to different etiologies of abdominal origin and who underwent CRS ± HIPEC were analyzed. The patients were divided into two groups according to whether the ERAS protocol was applied. Information on demographics, length of hospital stay, cost, morbidity, and mortality was statistically compared between groups.

RESULTS

A total of 102 patients were included in the study. The first 40 patients did not undergo the ERAS protocol, whereas 62 patients did undergo the protocol. The mean length of hospital stay was 10 days in the non-ERAS group and 7 days in the ERAS group. The ERAS group was observed to have earlier mobilization, earlier gas and stool release, lower oral intake, and fewer respiratory problems than the non-ERAS group.

CONCLUSION

CRS ± HIPEC has a positive effect on survival. The simultaneous application of the ERAS protocol with the aforementioned procedure has positive effects on intestinal motility and postoperative outcomes. In addition, this protocol may reduce costs by shortening the length of hospital stay.

摘要

引言

对于因腹腔内肿瘤导致的腹膜癌病(PC)患者,减瘤手术联合或不联合热灌注腹腔化疗(CRS±HIPEC)对其生存具有积极影响。目前,关于PC患者的加速康复外科(ERAS)方案安全性的现有文献不足,而该方案与严重的发病率和死亡率相关。

目的

本研究旨在展示我们使用ERAS方案治疗因腹腔内肿瘤引发的PC患者的结果。

材料与方法

分析了120例因不同腹部病因导致PC且接受CRS±HIPEC的连续患者的数据。根据是否应用ERAS方案将患者分为两组。对两组患者的人口统计学信息、住院时间、费用、发病率和死亡率进行统计学比较。

结果

本研究共纳入102例患者。前40例患者未采用ERAS方案,而62例患者采用了该方案。非ERAS组的平均住院时间为10天,ERAS组为7天。观察发现,与非ERAS组相比,ERAS组患者活动更早、排气和排便更早、口服摄入量更低且呼吸问题更少。

结论

CRS±HIPEC对生存有积极影响。将ERAS方案与上述手术同时应用对肠道蠕动和术后结果有积极影响。此外,该方案可能通过缩短住院时间降低费用。

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