增强根治性膀胱切除术术后恢复的最新进展。

IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY
Therapeutic Advances in Urology Pub Date : 2022-07-12 eCollection Date: 2022-01-01 DOI:10.1177/17562872221109022
Grace Lee, Hiren V Patel, Arnav Srivastava, Saum Ghodoussipour
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引用次数: 0

摘要

术后强化恢复(ERAS)是一种多模式路径,为改善手术患者的围手术期护理和预后提供循证指导。2013 年,ERAS 协会发布了针对膀胱癌(BC)根治性膀胱切除术(RC)的原始指南,其中大部分支持数据来自结直肠文献。过去十年间,人们对ERAS的兴趣与日俱增,针对膀胱癌根治术的ERAS研究也随之增加,其中包括前瞻性随机对照试验(RCT)。综合数据表明,ERAS 有助于提高并发症发生率、缩短住院时间和/或肠道恢复时间。不同的机构已经采用了ERAS路径的修改版本,但对于ERAS特定项目的疗效和方案的标准化仍缺乏共识。在本综述中,我们总结了自 2013 年最初的指南出台以来,针对 RC 的 ERAS 路径的最新证据和实践模式。我们还回顾了新的目标干预措施,包括使用免疫营养、预康复、阿维莫潘和局部镇痛方法。最后,我们讨论了推进 ERAS 运动的实施障碍和未来步骤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Updates on enhanced recovery after surgery for radical cystectomy.

Updates on enhanced recovery after surgery for radical cystectomy.

Updates on enhanced recovery after surgery for radical cystectomy.

Updates on enhanced recovery after surgery for radical cystectomy.

Enhanced Recovery after Surgery (ERAS) is a multimodal pathway that provides evidence-based guidance for improving perioperative care and outcomes in patients undergoing surgery. In 2013, the ERAS society released its original guidelines for radical cystectomy (RC) for bladder cancer (BC), adopting much of its supporting data from colorectal literature. In the last decade, growing interest in ERAS has increased RC-specific ERAS research, including prospective randomized controlled trials (RCTs). Collective data suggest ERAS contributes to improved complication rates, decreased hospital length-of-stay, and/or time to bowel recovery. Various institutions have adopted modified versions of the ERAS pathway, yet there remains a lack of consensus on the efficacy of specific ERAS items and standardization of the protocol. In this review, we summarize updated evidence and practice patterns of ERAS pathways for RC since the introduction of the original 2013 guidelines. Novel target interventions, including use of immunonutrition, prehabilitation, alvimopan, and methods of local analgesia are reviewed. Finally, we discuss barriers to implementing and future steps in advancing the ERAS movement.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
39
审稿时长
10 weeks
期刊介绍: Therapeutic Advances in Urology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of urology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in urology, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest across all areas of urology, including treatment of urological disorders, with a focus on emerging pharmacological therapies.
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