Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (9): 24-27.doi: 10.6040/j.issn.1671-7554.0.2019.533

Previous Articles    

Challenges and countermeasures in the spread of enhanced recovery after surgery

WANG Gang, JIANG Zhiwei   

  1. Department of General Surgery, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine;
    Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing 210029, Jiangsu, China)〓山〓东〓大〓学〓学〓报〓(医〓学〓版)57卷9期〓-王刚, 等.加速康复外科推广过程中面临的挑战与对策〓\=-
  • Published:2022-09-27

Abstract: The concept of perioperative enhanced recovery after surgery(ERAS)has been proposed and practiced forover 20 years. Clinical studies have been carried out in fields of gastrointestinal surgery, hepatobiliary surgery, orthopedics, obstetrics and gynecology, and urology at home and abroad. Results showed that ERAS could significantly shorten the recovery time of intestinal function, reduce the incidence of postoperative complications, shorten the length of hospitalization days and reduce hospital costs. Although the findings are encouraging, there are still obstacles restricting the development of EARS in China. In this review, the authors analyze the challenges of promoting ERAS, and propose countermeasures, hoping to provide ideas for the promotion of ERAS in China.

Key words: Enhanced recovery after surgery, Perioperative period, Multidisciplinary collaboration, Gastrectomy, Colorectal surgery

CLC Number: 

  • R69
[1] Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation[J]. Br J Anaesth, 1997, 78(5): 606-617.
[2] Vlug MS, Wind J, Hollmann MW, et al. Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery[J]. Ann Surg, 2011, 254(6): 868-875.
[3] Ren L, Zhu D, Wei Y, et al. Enhanced recovery after surgery(ERAS)program attenuates stress and accelerates recovery in patients after radical resection for colorectal cancer: a prospective randomized controlled trial[J]. World J Surg, 2012, 36(2): 407-414.
[4] Wang G, Jiang ZW, Xu J, et al. Fast-track rehabilitation program vs conventional care after colorectal resection: a randomized clinical trial[J]. World J Gastroenterol, 2011, 17(5): 671-676.
[5] Wang G, Jiang ZW, Zhao K, et al. Immunologic response after laparoscopic colon cancer operation within an enhanced recovery program[J]. J Gastrointest Surg, 2012, 16(7): 1379-1388.
[6] Wang G, Jiang ZW, Zhao K, et al. Fast track rehabilitation programme enhances functional recovery after laparoscopic colonic resection[J]. Hepatogastroenterology, 2012, 59(119): 2158-2163.
[7] 江志伟, 黎介寿, 汪志明, 等. 胃癌患者应用加速康复外科治疗的安全性及有效性研究[J]. 中华外科杂志, 2007, 45(19): 1314-1317. JIANG Zhiwei, LI Jieshou, WANG Zhiming, et al. The safety and efficiency of fast track surgery in gastric cancer patients undergoing D2 gastrectomy[J]. Chinese Journal of Surgery, 2007, 45(19): 1314-1317.
[8] Yilmaz G, Akça A, Aydin N, et al. Enhanced recovery after surgery(ERAS)versus conventional postoperative care in patients undergoing abdominal hysterectomies[J]. Ginekol Pol, 2018, 89(7): 351-356.
[9] Page AJ, Gani F, Crowley KT, et al. Patient outcomes and provider perceptions following implementation of a standardized perioperative care pathway for open liver resection[J]. Br J Surg, 2016, 103(5): 564-571.
[10] 江志伟, 李宁, 黎介寿. 快速康复外科的概念及临床意义[J]. 中国实用外科杂志, 2007, 27(2): 131-133.
[11] Veenhof AA, Vlug MS, van der Pas MH, et al. Surgical stress response and postoperative immune function after laparoscopy or open surgery with fast track or standard perioperative care: a randomized trial[J]. Ann Surg, 2012, 255(2): 216-221.
[12] Bakker N, Cakir H, Doodeman HJ, et al. Eight years of experience with enhanced recovery After Surgery in patients with colon cancer: Impact of measures to improve adherence[J]. Surgery, 2015, 157(8): 1130-1136.
[13] Stowers MDJ, Lemanu DP, Hill AG. Health economics in Enhanced Recovery After Surgery programs[J]. Can J Anaesth, 2015, 62(3): 219-230.
[14] Lee L, Mata J, Ghitulescu GA, et al. Cost-effectiveness of enhanced recovery versus conventional perioperative management for colorectal surgery[J]. Ann Surg, 2015, 262(10): 1026-1033.
[15] Nelson G, Kiyang LN, Crumley ET, et al. Implementation of Enhanced Recovery After Surgery(ERAS)across a provincial healthcare system: the ERAS Alberta Colorectal Surgery Experience[J]. World J Surg, 2016, 40(11): 1092-1103.
[16] Sammour T, Kahokehr A, Chan S, et al. The humoral response after laparoscopic versus open colorectal surgery: a meta-analysis[J]. J Surg Res, 2010, 164(1): 28-37.
[17] Gillissen F, Hoff C, Maessen JM, et al. Structured synchronous implementation of an enhanced recovery program in elective colonic surgery in 33 hospitals in The Netherlands[J]. World J Surg, 2013, 37(5): 1082-1093.
[18] Greco M, Capretti G, Beretta L, et al. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials[J]. World J Surg, 2014, 38(6): 1531-1541.
[19] Gustafsson UO, Oppelstrup H, Thorell A, et al. Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery: a retrospective cohort study[J]. World J Surg, 2016, 40(7): 1741-1747.
[20] Thanh NX, Chuck AW, Wasylak T, et al. An economic evaluation of the Enhanced Recovery After Surgery(ERAS)multisite implementation program for colorectal surgery in Alberta[J]. Can J Surg, 2016, 59(6): 415-421.
[21] Mortensen K, Nilsson M, Slim K, et al. Consensus guidelines for enhanced recovery after gastrectomy:Enhanced Recovery After Surgery(ERAS)Society recommendations[J]. Br J Surg, 2014, 101(10): 1209-1229.
[22] Gustafsson UO, Scott MJ, Schwenk W, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery(ERAS)Society recommendations[J]. Clin Nutr, 2012, 31(6): 783-800.
[23] Nygren J, Thacker J, Carli F, et al. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery(ERAS)Society recommendations[J]. Clin Nutr, 2012, 31(6): 801-816.
[24] Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery(ERAS)Society recommendations[J]. Clin Nutr, 2012, 31(6): 817-830.
[25] 江志伟, 李宁. 结直肠手术应用加速康复外科中国专家共识(2015版)[J]. 中国实用外科杂志, 2015, 35(8): 841-843. JIANG Zhiwei, LI Ning. Chinese consensus of enhanced recovery after surgery for colorectal surgery(2015)[J]. Chinese Journal of Practical Surgery, 2015, 35(8): 841-843.
[26] 陈凛,陈亚进,董海龙等. 加速康复外科中国专家共识及路径管理指南(2018版)[J]. 中国实用外科杂志, 2018, 38(1): 1-20. Chinese Society of Surgery, Chinese Society of Anesthesiology. Consensus on ERAS and guidelines for pathway management in China(2018)[J]. Chinese Journal of Practical Surgery, 2018, 38(1): 1-20.
[1] Mingwei ZHONG,Sanyuan HU. Exploration of surgical treatment of obesity by laparoscopic techniques in China [J]. Journal of Shandong University (Health Sciences), 2021, 59(9): 72-77, 96.
[2] WANG Bo, XIONG Ying, NI Zhifu, QU Zhenfan. Application of ERAS in day hernia surgery for children aged 1 to 3 years [J]. Journal of Shandong University (Health Sciences), 2020, 58(12): 92-96.
[3] LI Yujie, HAN Wei, HUANG Wei, DONG Yuke, LI Tao, DANG Yanwei, CAI Xiaoqing, SHEN Xiao, GONG Wendan, XU Lianfang. Application of enhanced recovery after surgery in 44 cases of uvulopalatopharyngoplasty [J]. Journal of Shandong University (Health Sciences), 2020, 58(11): 92-97.
[4] ZHI Mengwei, JIANG Zhiwei, DAI Xinjuan, WANG Gang, CHENG Wei. Clinical observation of heart rate variability in patients with gastric cancer during perioperative period under the guidance of enhanced recovery after surgery [J]. Journal of Shandong University (Health Sciences), 2020, 58(11): 85-91.
[5] JING Changqing, WANG Jinshen. Important role of evidence-based medicine in the application of enhanceel recovery aftev surgery in gastrointestinal surgery [J]. Journal of Shandong University (Health Sciences), 2019, 57(9): 18-23.
[6] SONG Xicheng, MA Jiahai. Anesthesia management under the guidance of enhanced recovery after surgevy concept [J]. Journal of Shandong University (Health Sciences), 2019, 57(9): 12-17.
[7] LI Leping, CUI Huaiping, SHANG Liang. Application of enhanced recovery after surgery in gastrointestinal surgery [J]. Journal of Shandong University (Health Sciences), 2019, 57(9): 5-11.
[8] JIANG Zhiwei, ZHOU Jiahui, CHENG Hui. Role of multimodal analgesia in enhanced recovery after surgery [J]. Journal of Shandong University (Health Sciences), 2019, 57(9): 1-4.
[9] DU Hao, CHENG Yugang, HUANG Xin, LIU Shaozhuang, ZHANG Guangyong, HU Sanyuan. Effects of sleeve gastrectomy on lung injury in type 2 diabetic rats [J]. Journal of Shandong University (Health Sciences), 2019, 57(4): 20-26.
[10] Establishment and management of menopause multidisciplinary comprehensive management clinicsBAI Wenpei, MAO Lele. Establishment and management of menopause multidisciplinary comprehensive management clinics [J]. Journal of Shandong University (Health Sciences), 2019, 57(2): 35-39.
[11] XIE Haibin, WU Qunzheng, LIU Shaozhuang, HUANG Xin, CHENG Yugang, HU Sanyuan, ZHANG Guangyong. Role of mitochondria-associated membranes in the improvement of insulin sensitivity in diabetic rats after sleeve gastrectomy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(10): 36-40.
[12] JIANG Jing-min, JIANG Yan-hua, YANG Cheng-lian. Application of integrated medical care for perioperative patients with extracrania-intracranial tumors of anterior skull bases [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(Z1): 166-167.
[13] WANG Jianjun1, ZHAO Zuohui1, SUN Bo1, PAN Yuzhen1, LI Shunlai1,
WANG Wanli1, DONG Gang1, MA Tianjia2
. The blood glucose, sodium, chloride, potassium and hematocrit of PKRP in the perioperative period [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(01): 95-97.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!