Ming Gedong,Zhu Hongxi,Chen Chen,et al.Application of fast-tract surgery in laparoscopic treatment of children with complicated appendicitis[J].Journal of Clinical Pediatric Surgery,,18():600-605.[doi:10.3969/j.issn.1671-6353.2019.07.016]
Application of fast-tract surgery in laparoscopic treatment of children with complicated appendicitis
- CLC:
- R656.8;R616.5;R762
- Abstract:
- Objective To explore the effectiveness and safety of ERAS in laparoscopic treatment of children with complicated appendicitis.Methods Respective analysis was performed for 58 hospitalized children with complicated appendicitis from March 2017 to April 2018.Based upon the condition of children and parental wishes,they were randomly divided into ERAS and controlled groups (n=29 each).Laparoscopy was performed in both groups.The group of ERAS adopted ERAS while controlled group adopted traditional program.Two groups were compared with regards to initial feeding time,anus exhausting time,postoperative activity time,hospital stay,incidence of surgical complications,hospitalization expense and patient satisfaction.Results All children recovered and discharged.The initial feeding time of ERAS group was less than that of controlled group[(12.11±2.23) vs (24.62±3.28) h]; the anus exhausting time of ERAS group was earlier than that of controlled group[(26.61±12.30) vs (44.63±17.28) h]; the postoperative activity time of ERAS group was less than that of controlled group[(9.17±1.35) vs (24.75±2.85) h]; the hospital stay of ERAS group was shorter than that of controlled group[(4.23±1.18) vs (6.15±1.49) days]; the hospitalization expense of ERAS group was lower than that of controlled group[(9948.12±105.36) vs (12131.65±132.29) yuan]; the patient score of ERAS group was lower than that of controlled group[(2.35±0.26) vs (5.48±0.79)]; the patient satisfaction of ERAS group was much higher than that of controlled group (96.55% vs 75.86%).Laparoscopic appendectomy resulted in lower complications rate and shorter postoperative hospital stay than open appendectomy.All comparisons had significant differences.One case of ERAS group had complications after surgery (3.44%) while two cases of controlled group had complications (6.90%).There was no statistically significant difference.During a follow-up period of 3 months,there was no occurrence of such severe complications as infection of incisional wound,appendix stump inflammation or adhesive ileus,etc.Conclusion The application of ERAS in laparoscopic treatment of children with complicated appendicitis can enhance postoperative recovery,shorten hospital stay,improve patient satisfaction and add no extra financial burden.Both safe and effective,this procedure may be further popularized.
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Memo
收稿日期:2018-6-11。
基金项目:江苏省盐城市医学科技发展计划项目（编号：YK2017045）；江苏省妇幼健康科研项目（编号：F201854）
通讯作者:朱鸿喜,Email:401485@qq.com