Xiong Xiaofeng,Feng Jiexiong.Further improving the outcomes of mini-invasive surgery in children[J].Journal of Clinical Pediatric Surgery,2024,(01):1-5.[doi:10.3760/cma.j.cn101785-202311016-001]
关于儿童微创外科的几点反思
- Title:
- Further improving the outcomes of mini-invasive surgery in children
- 摘要:
- 微创手术已经在小儿外科大量应用并取得了良好的治疗效果,但在目前临床实践中,儿童微创手术普遍存在"重外观、轻功能"等问题,尚缺乏针对小儿微创外科的科学的内涵定义与评价标准,术前准确决策、术中完整清除目标病灶、损伤控制以及合理的手术方式等一系列体现手术精准化的策略需要进一步加强,围手术期实施加速康复外科方案以及有效的营养管理、心理干预等一系列旨在达到功能性微创理念的具体措施还有待进一步优化。进一步提高儿童微创手术治疗效果,必须将功能性微创理念贯穿到术前诊断评估和营养管理、手术规划、手术操作、加速康复外科等整个外科诊断与治疗过程,制订个体化诊断与治疗方案,以患者器官及整体功能恢复作为评价标准。
- Abstract:
- Mini-invasive surgery has been widely applied during pediatric surgery and it has achieved satisfactory outcomes.However,there are still such practical problems as emphasizing incisional appearance and neglecting functional recovery.There is also a lack of evaluation standards for pediatric mini-invasive surgery.Accurate preoperative decision-making,removing target lesions,intraoperative injury control and rational surgical approaches should be strengthened.Measures and concepts of functional mini-invasive surgery,such as accelerated rehabilitation,effective nutrition management and perioperative psychological interventions,require refining.The concept of functional mini-invasive surgery must be integrated into the entire surgical management processes of preoperative diagnoses,evaluations,nutritional managements,surgical procedures and ERAS.Individualized protocols should be developed and the recovery of patient organs and overall functions adopted as the evaluation criteria.
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备注/Memo
收稿日期:2023-11-12。
基金项目:湖北省科技创新基地平台专项(2020DCD006);湖北省重点研发计划(2023BCB095)
通讯作者:冯杰雄,Email:fengjiexiong@126.com