增强恢复独立降低了结肠直肠手术后未能救援的失败
Marco Catarci1, Giacomo Ruffo2, Massimo Giuseppe Viola3
1General Surgery Unit, Sandro Pertini Hospital, ASL Roma 2, Roma, Italy.
Diseases of the colon and rectum
|February 11, 2025
概括
对手术后增强恢复 (ERAS) 途径的高度坚持显著降低了接受选择性结直肠手术的患者的救援失败率. 独立地达到70%以上的遵守率会降低这些关键结果.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 外科手术的结果
- 患者恢复途径 患者恢复途径
背景情况:
- 已知手术后增强恢复 (ERAS) 途径可降低发病率和死亡率.
- 优化遵守ERAS协议对于改善外科手术结果至关重要.
研究的目的:
- 调查遵守ERAS途径对未能救助 (FTR) 率的影响.
- 确定在选择性结直肠手术后影响FTR的因素.
主要方法:
- 来自78个意大利中心 (2019-2021) 的前数据库的回顾性分析.
- 包括因良性或恶性疾病而接受选择性结直肠切除的成年患者.
- FTR定义为死亡数除以不良事件;物流回归确定了预测因素.
主要成果:
- 在8359名患者中,不良事件发生在27.8%的患者中;重大不良事件发生在6.3%的患者中;死亡发生在1.0%的患者中.
- FTR率为3.8% (任何不良事件) 和16.8% (重大不良事件).
- 坚持ERAS路径>70%独立降低了FTR率.
结论:
- 对ERAS路径的高度坚持 (>70%) 是防止救援失败的独立保护因素.
- 与患者相关的 (年龄,ASA类,营养) 和与治疗相关的因素 (切除类型,静脉漏,重新手术) 也可以预测结果.
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