Zhao Hangyan,Liu Xiwang,Ying Liyang,et al.Application of Enhanced Recovery Surgery in Pediatric Robotic Arteriosus Catheter Ligation Day Surgery[J].Journal of Clinical Pediatric Surgery,,():924-928.[doi:10.3760/cma.j.cn101785-202402013-005]
Application of Enhanced Recovery Surgery in Pediatric Robotic Arteriosus Catheter Ligation Day Surgery
- Keywords:
- Enhanced Recovery After Surgery; Robotic Surgical Procedures; Day Surgery; Patent Ductus Arteriosus; Child
- Abstract:
- Objective To investigate the feasibility and clinical efficacy of a day surgery management model in pediatric patients undergoing robot-assisted patent ductus arteriosus(PDA) ligation as a day surgery. Methods This retrospective study included 275 PDA children undergoing Da Vinci robot assisted endoscopy at the Children’s Hospital, Zhejiang University School of Medicine, from August 2020 to October 2023.Patients were divided into two groups:the day surgery group (n=120) managed with a day surgery approach under ERAS protocol, and the control group (n=155) managed with conventional inpatient surgery approach under ERAS protocol .The two groups were compared for differences in surgery duration, preoperative fasting time, time to first postoperative fluid intake, postoperative pain scores, incidence of postoperative complications, surgery cancellation rate on the day of surgery, parental satisfaction, length of hospital stay, and total hospitalization costs. Results The day surgery group had a significantly shorter preoperative fasting duration (136.18±23.05 min vs.339.28±111.274 min), time to first postoperative fluid intake (63.14±12.841 min vs.168.33±59.516 min), length of hospital stay (1.00±0.00 days vs.2.72±2.25 days), and total hospitalization costs (51 760±1 350 RMB vs.53 330±1 870 RMB) compared to the control group (P<0.05).The surgery cancellation rate on the day of surgery was significantly lower in the day surgery group [1.64% (2/120) vs.9.88%(17/155), P<0.05].The incidence of postoperative fever [7.50%(9/120) vs.38.06% (59/155)] and residual leakage [0.83% (1/120) vs.7.10% (11/155)] was significantly lower in the day surgery group (P<0.05), but there was no statistically significant difference in postoperative hoarseness.Postoperative pain scores were similar between the two groups (0.83±1.23 vs.0.78±1.10, P>0.05). Conclusions The application of the day surgery management model under ERAS protocol in pediatric robot-assisted PDA ligation significantly reduces the length of hospital stay and total hospitalization costs, optimizes the healthcare experience for children and their parents and does not increase the incidence of postoperative complications, making it a safe and feasible approach in clinical practice.
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Memo
收稿日期:2024-2-19。
基金项目:浙江省中医药科技计划项目(2023ZL499)
通讯作者:舒强,Email:shuqiang@zju.edu.cn