加速康复外科在根治性全膀胱切除及尿流改道术的应用现状及探讨
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摘要
加速康复外科(ERAS)最先提出于结直肠手术,目的在于减少患者术后并发症,缩短住院时间,使患者能够更快康复,降低医疗资源浪费,缩减患者花费。这一理念在不断的发展和完善的同时推广到很多学科,其中也经历很多波折,因为ERAS的具体措施有很多是与传统的外科教条相矛盾的。对此,我们探讨ERAS在全膀胱切除及尿流改道术的应用,并做一综述。
Enhance recovery after surgery(ERAS)was first put forward in colorectal surgery to reduce postop?erative morbidity,shorten length of hospital stay,help patients rehabilitate faster,greatly reduce the waste of medical resources to a certain extent,besides for the cost of patients. The concept was brought into China from the west,un?der increasingly development and improvement,spread to many disciplines. Because the measures of ERAS have many contradictories to the traditional surgical dogmas,it caused many obstructions. This review discussed the appli?cation of ERAS in radical cystectomy and urinary diversion for bladder cancer.
Enhance recovery after surgery(ERAS)was first put forward in colorectal surgery to reduce postop?erative morbidity,shorten length of hospital stay,help patients rehabilitate faster,greatly reduce the waste of medical resources to a certain extent,besides for the cost of patients. The concept was brought into China from the west,un?der increasingly development and improvement,spread to many disciplines. Because the measures of ERAS have many contradictories to the traditional surgical dogmas,it caused many obstructions. This review discussed the appli?cation of ERAS in radical cystectomy and urinary diversion for bladder cancer.
引文
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[3] MIRVALD C, SURCEL C, GINGU C, et al.C134:early complication rates and perioperativemortality after radical cystectomy in the elderly. EurUrol Suppl,2014,13(6):1319-1320.
[4] HAUTMANN RE,DE PETRICONI RC,VOLK?MER BG. Lessons learned from 1,000 neobladders:the 90-Day complication rate. J Urol,2010,184(3):990-994.
[5] Rink M. How to prevent and reduce the complicationrate in patients eligible for radical cystectomy? EurUrol Suppl,2017,16(2):74-75.
[6] STIMSON CJ,CHANG SS,BAROCAS DA,etal. Early and late perioperative outcomes followingradical cystectomy:90-Day readmissions,morbidityand mortality in a contemporary series. J Urol,2010,184(4):1296-1300.
[7] KEHLET H. Multimodal approach to control post?operative pathophysiology and rehabilitation. Br JAnaesth,1997,78(5):606-617.
[8] PATEL HR,CERANTOLA Y,VALERIO MA,et al. Enhanced recovery after surgery:are weready,and can we afford not to implement thesepathways for patients undergoing radical cystecto?my? Eur Urol,2014,65(2):263-266.
[9] SEMERJIAN A,MILBAR N,KATES M,et al.Hospital charges and length of stay following radicalcystectomy in the enhanced recovery after surgeryera. Urology,2018,111:86-91.
[10] PANG KH,GROVES R,VENUGOPAL S,et al.The application of ERAS pathways to radical cystec?tomy:outcomes from 482 consecutive cases. EurUrol Suppl,2017,16(3):e1023.
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[13] DANESHMAND S, AHMADI H, SCHUCK?MAN AK,et al. Enhanced recovery protocol afterradical cystectomy for bladder cancer. J Urol,2014,192(1):50-55.
[14] COLLINS JW,PATEL HB,ADDING CA,et al.Enhanced recovery after robot-assisted radical cystec?tomy:EAU robotic urology section scientific work?ing group consensus view. Eur Urol,2016,70(4):649-660.
[15] DJALADAT H,KATEBIAN B,BAZARGANIST,et al. 90-Day complication rate in patients under?going radical cystectomy with enhanced recovery pro?tocol:a prospective cohort study. World J Urol,2017,35(6):907-911.
[16] JOHNSON DC,RIGGS SB,NIELSEN ME,etal. Nutritional predictors of complications followingradical cystectomy. World J Urol,2015,33(8):1129-1137.
[17] TOBERT CM,HAMILTON-REEVES JM,NORI?AN LA,et al. Emerging impact of malnutrition onsurgical patients:literature review and potential im?plications for cystectomy in bladder cancer. J Urol,2017,198(3):511-518.
[18] BAHAT G,TUFAN F,TUFAN A,et al. TheESPEN guidelines on enteral nutrition-Geriatrics:Need for its promotion in practice. Clin Nutr,2016,35(4):985.
[19] TURAN A,KOYUNCU O,EGAN C,et al. Ef?fect of various durations of smoking cessation onpostoperative outcomes:A retrospective cohort anal?ysis. Eur J Anaesthesiol,2018,35(4):256-265.
[20] GIERTH M,ZEMAN F,DENZINGER S,et al.Influence of body mass index on clinical outcome pa?rameters,complication rate and survival after radicalcystectomy:evidence from a prospective Europeanmulticentre study. Urol Int,2018,101(1):16-24.
[21] JENSEN BT,KIESBYE B,SOENDERGAARDIA,et al. Efficacy of preoperative uro-stoma educa?tion on self-efficacy after radical cystectomy;second?ary outcome of a prospective randomized controlledtrial. Eur J Oncol Nurs,2017,28:41-46.
[22] CERANTOLA Y,VALERIO M,PERSSON B,et al. Guidelines for perioperative care after radicalcystectomy for bladder cancer:Enhanced RecoveryAfter Surgery(ERAS(?))society recommenda?tions. Clin Nutr,2013,32(6):879-887.
[23] CARAS RJ,LUSTIK MB,KERN SQ,et al. Pre?operative albumin is predictive of early postoperativemorbidity and mortality in common urologic oncolog?ic surgeries. Clin Genitourin Cancer,2017,15(2):e255-e262.
[24] PRUTHI RS,NIELSEN M,SMITH A,et al.Fast track program in patients undergoing radical cys?tectomy:results in 362 consecutive patients. J AmColl Surg,2010,210(1):93-99.
[25] PERSSON B,CARRINGER M,ANDRéN O,etal. Initial experiences with the enhanced recovery af?ter surgery(ERAS)protocol in open radical cystec?tomy. Scand J Urol,2015,49(4):302-307.
[26] JEFFREY L,ROBERT A,RICHARD T,et al.Practice guidelines for preoperative fasting and theuse of pharmacologic agents to reduce the risk of pul?monary aspiration:application to healthy patients un?dergoing elective procedures. Anesthesiology,2011,114(3):495-511.
[27] VANDLAC AA,COWAN NG,CHEN YY,et al.Timing,incidence and risk factors for venous throm?boembolism in patients undergoing radical cystecto?my for malignancy:a case for extended durationpharmacological prophylaxis. J Urol,2014,191(4):943-947.
[28] NELSON RL,GLENNY AM,SONG FJ. Antimi?crobial prophylaxis for colorectal surgery. CochraneDatabase Syst Rev,2009,5(1):CD001181
[29] STEIN JP,LIESKOVSKY G,COTE R,et al.Radical cystectomy in the treatment of invasive blad?der cancer:long-term results in 1,054 patients. JClin Oncol,2001,19(3):666-675.
[30] TANG K,LI H,XIA D,et al. Laparoscopic versusopen radical cystectomy in bladder cancer:a system?atic review and meta-analysis of comparative studies.PLoS One,2014,9(5):e95667.
[31] THIELE RH,RAGHUNATHAN K,BRUDNEYCS,et al. American society for enhanced recovery(ASER)and perioperative quality initiative(POQI)joint consensus statement on perioperative fluid man?agement within an enhanced recovery pathway forcolorectal surgery. Perioper Med(Lond),2016,5(5):24.
[32] WUELLNER L,SUTTON L. Intraoperative fluidmanagement guided by esophageal Doppler monitor?ing in major abdominal surgery utilizing the enhancedrecovery after surgery program:a systematic reviewprotocol. JBI Database System Rev Implement Rep,2016,14(7):3-10.
[33] PATEL SY,GARCIA GETTING RE,ALFORDB,et al. Improved outcomes of enhanced recoveryafter surgery(ERAS)protocol for radical cystecto?my with addition of a multidisciplinary care processin a US comprehensive cancer care center. World JSurg,2018,42:2701-2707.
[34] LIN TX,LI KW,LIU H,et al. Enhanced recoveryafter surgery for radical cystectomy with ileal urinarydiversion:a multi-institutional,randomized,con?trolled trial from the Chinese bladder cancer consor?tium. World J Urol,2018,36(1):41-50.
[35] MATTEI AB, BAERMANN C, WARNCKESH,et al. To stent or not to stent perioperatively theureteroileal anastomosis of ileal orthotopic bladdersubstitutes and ileal conduits? Results of a prospec?tive randomized trial. J Urol,2008,179(2):582-586.
[36]中华医学会泌尿外科学分会膀胱癌联盟加速康复外科专家协作组.根治性膀胱切除及尿流改道术加速康复外科专家共识.中华泌尿外科杂志.2018,7(39):481-484.
[37] ADDING C,COLLINS JW,LAURIN O,et al.Enhanced recovery protocols(ERP)in robotic cystec?tomy surgery. Review of current status and trends.Curr Urol Rep,2015,16(5):32-43.
[38] GóMEZ RIVAS J,ALONSO Y GREGORIO S,CISNEROS LEDO J,et al. Early recovery protocolin patients undergoing laparoscopic radical cystecto?my. Urological Science,2017,28(1):2-5.
[39] LEE CT,CHANG SS,KAMAT AM,et al. Alvi?mopan accelerates gastrointestinal recovery after radi?cal cystectomy:a multicenter randomized placebo-controlled trial. Eur Urol,2014,66(2):265-272.
[40] KOUBA EJ,WALLEN EM,PRUTHI RS. Gumchewing stimulates bowel motility in patients under?going radical cystectomy with urinary diversion.Urology,2007,70(6):1053-1056.
[41] ASAO T,KUWANO H,NAKAMURA J,et al.Gum chewing enhances early recovery from postoper?ative ileus after laparoscopic colectomy. J Am CollSurg,2002,195(1):30-32.
[42] XU W,DANESHMAND S,BAZARGANI ST,et al. Postoperative pain management after radicalcystectomy:comparing traditional versus enhancedrecovery protocol pathway. J Urol,2015,194(5):1209-1213.
[43] RAHBARI NN,ZIMMERMANN JB,SCHMIDTT,et al. Meta-analysis of standard,restrictive andsupplemental fluid administration in colorectal sur?gery. Br J Surg,2009,96(4):331-341.
[44] YILMAZ N,CEKMEN N,BILGIN F,et al. Pre?operative carbohydrate nutrition reduces postopera?tive nausea and vomiting compared to preoperativefasting. J Res Med Sci,2013,18(10):827-832.
[45] HOLZHAUER C,WEIJERMAN PC,SMITS GAHJ,et al. ERAS-protocol effective for Robot-As?sisted Cystectomy(RARC)standardization wanted.European Urology Supplements, 2016,15(7):222-223.
[2]那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南.北京:人民卫生出版社,2014:20–60.
[3] MIRVALD C, SURCEL C, GINGU C, et al.C134:early complication rates and perioperativemortality after radical cystectomy in the elderly. EurUrol Suppl,2014,13(6):1319-1320.
[4] HAUTMANN RE,DE PETRICONI RC,VOLK?MER BG. Lessons learned from 1,000 neobladders:the 90-Day complication rate. J Urol,2010,184(3):990-994.
[5] Rink M. How to prevent and reduce the complicationrate in patients eligible for radical cystectomy? EurUrol Suppl,2017,16(2):74-75.
[6] STIMSON CJ,CHANG SS,BAROCAS DA,etal. Early and late perioperative outcomes followingradical cystectomy:90-Day readmissions,morbidityand mortality in a contemporary series. J Urol,2010,184(4):1296-1300.
[7] KEHLET H. Multimodal approach to control post?operative pathophysiology and rehabilitation. Br JAnaesth,1997,78(5):606-617.
[8] PATEL HR,CERANTOLA Y,VALERIO MA,et al. Enhanced recovery after surgery:are weready,and can we afford not to implement thesepathways for patients undergoing radical cystecto?my? Eur Urol,2014,65(2):263-266.
[9] SEMERJIAN A,MILBAR N,KATES M,et al.Hospital charges and length of stay following radicalcystectomy in the enhanced recovery after surgeryera. Urology,2018,111:86-91.
[10] PANG KH,GROVES R,VENUGOPAL S,et al.The application of ERAS pathways to radical cystec?tomy:outcomes from 482 consecutive cases. EurUrol Suppl,2017,16(3):e1023.
[11] FREES SP. A prospective randomized single-centretrial evaluating an ERAS protocol versus a standardprotocol for patients treated with radical cystectomyand urinary diversion for bladder cancer. Eur UrolSuppl,2017,16(3):1024-1025.
[12] MüLLER S,LILLEAASEN G,DAVAMI J,etal. Enhanced recovery after radical cystectomy-re?sults of the first 18 months after implementation of afull ERAS program using the EIAS database. EurUrol Suppl,2017,16(3):e1028-e1029.
[13] DANESHMAND S, AHMADI H, SCHUCK?MAN AK,et al. Enhanced recovery protocol afterradical cystectomy for bladder cancer. J Urol,2014,192(1):50-55.
[14] COLLINS JW,PATEL HB,ADDING CA,et al.Enhanced recovery after robot-assisted radical cystec?tomy:EAU robotic urology section scientific work?ing group consensus view. Eur Urol,2016,70(4):649-660.
[15] DJALADAT H,KATEBIAN B,BAZARGANIST,et al. 90-Day complication rate in patients under?going radical cystectomy with enhanced recovery pro?tocol:a prospective cohort study. World J Urol,2017,35(6):907-911.
[16] JOHNSON DC,RIGGS SB,NIELSEN ME,etal. Nutritional predictors of complications followingradical cystectomy. World J Urol,2015,33(8):1129-1137.
[17] TOBERT CM,HAMILTON-REEVES JM,NORI?AN LA,et al. Emerging impact of malnutrition onsurgical patients:literature review and potential im?plications for cystectomy in bladder cancer. J Urol,2017,198(3):511-518.
[18] BAHAT G,TUFAN F,TUFAN A,et al. TheESPEN guidelines on enteral nutrition-Geriatrics:Need for its promotion in practice. Clin Nutr,2016,35(4):985.
[19] TURAN A,KOYUNCU O,EGAN C,et al. Ef?fect of various durations of smoking cessation onpostoperative outcomes:A retrospective cohort anal?ysis. Eur J Anaesthesiol,2018,35(4):256-265.
[20] GIERTH M,ZEMAN F,DENZINGER S,et al.Influence of body mass index on clinical outcome pa?rameters,complication rate and survival after radicalcystectomy:evidence from a prospective Europeanmulticentre study. Urol Int,2018,101(1):16-24.
[21] JENSEN BT,KIESBYE B,SOENDERGAARDIA,et al. Efficacy of preoperative uro-stoma educa?tion on self-efficacy after radical cystectomy;second?ary outcome of a prospective randomized controlledtrial. Eur J Oncol Nurs,2017,28:41-46.
[22] CERANTOLA Y,VALERIO M,PERSSON B,et al. Guidelines for perioperative care after radicalcystectomy for bladder cancer:Enhanced RecoveryAfter Surgery(ERAS(?))society recommenda?tions. Clin Nutr,2013,32(6):879-887.
[23] CARAS RJ,LUSTIK MB,KERN SQ,et al. Pre?operative albumin is predictive of early postoperativemorbidity and mortality in common urologic oncolog?ic surgeries. Clin Genitourin Cancer,2017,15(2):e255-e262.
[24] PRUTHI RS,NIELSEN M,SMITH A,et al.Fast track program in patients undergoing radical cys?tectomy:results in 362 consecutive patients. J AmColl Surg,2010,210(1):93-99.
[25] PERSSON B,CARRINGER M,ANDRéN O,etal. Initial experiences with the enhanced recovery af?ter surgery(ERAS)protocol in open radical cystec?tomy. Scand J Urol,2015,49(4):302-307.
[26] JEFFREY L,ROBERT A,RICHARD T,et al.Practice guidelines for preoperative fasting and theuse of pharmacologic agents to reduce the risk of pul?monary aspiration:application to healthy patients un?dergoing elective procedures. Anesthesiology,2011,114(3):495-511.
[27] VANDLAC AA,COWAN NG,CHEN YY,et al.Timing,incidence and risk factors for venous throm?boembolism in patients undergoing radical cystecto?my for malignancy:a case for extended durationpharmacological prophylaxis. J Urol,2014,191(4):943-947.
[28] NELSON RL,GLENNY AM,SONG FJ. Antimi?crobial prophylaxis for colorectal surgery. CochraneDatabase Syst Rev,2009,5(1):CD001181
[29] STEIN JP,LIESKOVSKY G,COTE R,et al.Radical cystectomy in the treatment of invasive blad?der cancer:long-term results in 1,054 patients. JClin Oncol,2001,19(3):666-675.
[30] TANG K,LI H,XIA D,et al. Laparoscopic versusopen radical cystectomy in bladder cancer:a system?atic review and meta-analysis of comparative studies.PLoS One,2014,9(5):e95667.
[31] THIELE RH,RAGHUNATHAN K,BRUDNEYCS,et al. American society for enhanced recovery(ASER)and perioperative quality initiative(POQI)joint consensus statement on perioperative fluid man?agement within an enhanced recovery pathway forcolorectal surgery. Perioper Med(Lond),2016,5(5):24.
[32] WUELLNER L,SUTTON L. Intraoperative fluidmanagement guided by esophageal Doppler monitor?ing in major abdominal surgery utilizing the enhancedrecovery after surgery program:a systematic reviewprotocol. JBI Database System Rev Implement Rep,2016,14(7):3-10.
[33] PATEL SY,GARCIA GETTING RE,ALFORDB,et al. Improved outcomes of enhanced recoveryafter surgery(ERAS)protocol for radical cystecto?my with addition of a multidisciplinary care processin a US comprehensive cancer care center. World JSurg,2018,42:2701-2707.
[34] LIN TX,LI KW,LIU H,et al. Enhanced recoveryafter surgery for radical cystectomy with ileal urinarydiversion:a multi-institutional,randomized,con?trolled trial from the Chinese bladder cancer consor?tium. World J Urol,2018,36(1):41-50.
[35] MATTEI AB, BAERMANN C, WARNCKESH,et al. To stent or not to stent perioperatively theureteroileal anastomosis of ileal orthotopic bladdersubstitutes and ileal conduits? Results of a prospec?tive randomized trial. J Urol,2008,179(2):582-586.
[36]中华医学会泌尿外科学分会膀胱癌联盟加速康复外科专家协作组.根治性膀胱切除及尿流改道术加速康复外科专家共识.中华泌尿外科杂志.2018,7(39):481-484.
[37] ADDING C,COLLINS JW,LAURIN O,et al.Enhanced recovery protocols(ERP)in robotic cystec?tomy surgery. Review of current status and trends.Curr Urol Rep,2015,16(5):32-43.
[38] GóMEZ RIVAS J,ALONSO Y GREGORIO S,CISNEROS LEDO J,et al. Early recovery protocolin patients undergoing laparoscopic radical cystecto?my. Urological Science,2017,28(1):2-5.
[39] LEE CT,CHANG SS,KAMAT AM,et al. Alvi?mopan accelerates gastrointestinal recovery after radi?cal cystectomy:a multicenter randomized placebo-controlled trial. Eur Urol,2014,66(2):265-272.
[40] KOUBA EJ,WALLEN EM,PRUTHI RS. Gumchewing stimulates bowel motility in patients under?going radical cystectomy with urinary diversion.Urology,2007,70(6):1053-1056.
[41] ASAO T,KUWANO H,NAKAMURA J,et al.Gum chewing enhances early recovery from postoper?ative ileus after laparoscopic colectomy. J Am CollSurg,2002,195(1):30-32.
[42] XU W,DANESHMAND S,BAZARGANI ST,et al. Postoperative pain management after radicalcystectomy:comparing traditional versus enhancedrecovery protocol pathway. J Urol,2015,194(5):1209-1213.
[43] RAHBARI NN,ZIMMERMANN JB,SCHMIDTT,et al. Meta-analysis of standard,restrictive andsupplemental fluid administration in colorectal sur?gery. Br J Surg,2009,96(4):331-341.
[44] YILMAZ N,CEKMEN N,BILGIN F,et al. Pre?operative carbohydrate nutrition reduces postopera?tive nausea and vomiting compared to preoperativefasting. J Res Med Sci,2013,18(10):827-832.
[45] HOLZHAUER C,WEIJERMAN PC,SMITS GAHJ,et al. ERAS-protocol effective for Robot-As?sisted Cystectomy(RARC)standardization wanted.European Urology Supplements, 2016,15(7):222-223.