Enhanced recovery after surgery in liver transplantation: Challenges and feasibility.

世界移植杂志(英文版) Pub Date : 2022-07-18 DOI:10.5500/wjt.v12.i7.195

Georgios Katsanos, Konstantina-Eleni Karakasi, Nikolaos Antoniadis, Stella Vasileiadou, Athanasios Kofinas, Antonios Morsi-Yeroyannis, Evangelia Michailidou, Ioannis Goulis, Emmanouil Sinakos, Olga Giouleme, Ilias Marios Oikonomou, George Evlavis, Georgios Tsakiris, Eleni Massa, Eleni Mouloudi, Georgios Tsoulfas

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引用次数: 3

Abstract

Background: Enhanced recovery after surgery (ERAS) started a revolution that changed age-old surgical stereotypical practices regarding the overall management of the surgical patient. In the last decade, ERAS has gained significant acceptance in the community of general surgery, in addition to several other surgical specialties, as the evidence of its advantages continues to grow. One of the last remaining fields, given its significant complexity and intricate nature, is liver transplantation (LT).

Aim: To investigate the existing efforts at implementing ERAS in LT.

Methods: We conducted a systematic review of the existing studies that evaluate ERAS in orthotopic LT, with a multimodal approach and focusing on measurable clinical primary endpoints, namely length of hospital stay.

Results: All studies demonstrated a considerable decrease in length of hospital stay, with no readmission or negative impact of the ERAS protocol applied to the postoperative course.

Conclusions: ERAS is a well-validated multimodal approach for almost all types of surgical procedures, and its future in selected LT patients seems promising, as the preliminary results advocate for the safety and efficacy of ERAS in the field of LT.

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肝移植术后增强恢复:挑战与可行性。

背景:增强术后恢复(ERAS)开始了一场革命，改变了关于手术患者整体管理的古老的外科刻板做法。在过去的十年中，ERAS在普通外科以及其他一些外科专业中获得了显著的认可，因为其优势的证据在不断增长。鉴于其显著的复杂性和复杂的性质，最后剩下的领域之一是肝移植(LT)。目的:调查在原位肝移植中实施ERAS的现有努力。方法:我们对评估原位肝移植ERAS的现有研究进行了系统回顾，采用多模式方法，重点关注可测量的临床主要终点，即住院时间。结果:所有研究均显示住院时间显著缩短，无再入院或ERAS方案应用于术后过程的负面影响。结论:ERAS是一种经过良好验证的多模式方法，适用于几乎所有类型的外科手术，由于初步结果支持ERAS在LT领域的安全性和有效性，因此其在选定的LT患者中的前景似乎很有希望。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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世界移植杂志(英文版)

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