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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Optimizing ERAS protocols in robotic nephron-sparing surgery: a randomized trial.

Yiqiang Wang1, Mangmang He2, Lulu Lou3

  • 1Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang Province, 310007, China.

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Summary

Enhanced Recovery After Surgery (ERAS) nursing protocols significantly improve patient recovery after robotic partial nephrectomy, reducing complications and hospital stays. This evidence-based approach enhances patient comfort and supports wider clinical use.

Keywords:
Da Vinci surgical systemEnhanced recovery after surgeryKidney neoplasmsPartial nephrectomyPerioperative careRandomized controlled trialRobotic-assisted surgery

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Area of Science:

  • Urology
  • Surgical Nursing
  • Robotic Surgery

Background:

  • Robotic-assisted partial nephrectomy is a common procedure for kidney tumors.
  • Optimizing postoperative recovery is crucial for patient outcomes and healthcare efficiency.

Purpose of the Study:

  • To evaluate the clinical efficacy of evidence-based Enhanced Recovery After Surgery (ERAS) nursing protocols.
  • To compare ERAS protocols against conventional care in patients undergoing robotic-assisted partial nephrectomy.

Main Methods:

  • A randomized controlled trial involving 240 patients undergoing Da Vinci robot-assisted partial nephrectomy.
  • Patients were allocated to either ERAS (n=120) or conventional care (n=120) groups.
  • Primary outcomes included operative time, blood loss, and hospital stay; secondary outcomes assessed complications and patient comfort.

Main Results:

  • The ERAS group showed significantly shorter operative times (228.6 vs. 252.8 min) and reduced blood loss (200.4 vs. 232.6 mL).
  • Hospital stay was markedly reduced in the ERAS group (6.2 vs. 10.5 days), with faster ambulation and catheter removal.
  • ERAS significantly lowered complication rates (14.2% vs. 39.2%), including urinary infections and wound hematomas, and improved patient-reported comfort.

Conclusions:

  • Evidence-based ERAS nursing protocols significantly enhance postoperative recovery in robotic-assisted partial nephrectomy.
  • ERAS implementation leads to reduced complications and improved patient comfort.
  • These findings support the broader clinical adoption of ERAS protocols for this surgical procedure.