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Chinese Journal of Hepatic Surgery(Electronic Edition) ›› 2019, Vol. 08 ›› Issue (04): 320-324. doi: 10.3877/cma.j.issn.2095-3232.2019.04.010

Special Issue:

• Clinical Researches • Previous Articles     Next Articles

Application of enhanced recovery after surgery in laparoscopic radical resection of hepatic cystic echinococcosis

Yuan Meng1, Kalifu Baheti1, Zhigang Ma1, Jinguo Wang1, Shuang Lu1, Abula Yimamu1, Wei Song1, Guanglei Tian1, Ming Ma1, Xiong Chen1,()   

  1. 1. Department of Hepatobiliary Surgery, Xinjiang Uygur Municipal People's Hospital, Urumqi 830001, China
  • Received:2019-03-18 Online:2019-08-10 Published:2019-08-10
  • Contact: Xiong Chen
  • About author:
    Corresponding author: Chen Xiong, Email:

Abstract:

Objective

To explore the application value of enhanced recovery after surgery (ERAS) in the laparoscopic radical resection of hepatic cystic echinococcosis.

Methods

Clinical data of 38 patients with hepatic cystic echinococcosis undergoing laparoscopic total external cystectomy in Xinjiang Uygur Municipal People's Hospital from January 2016 to November 2017 were retrospectively analyzed. Among them, 24 patients were male and 14 female, aged 17-70 years with a median age of 46 years. The informed consents of all patients were obtained and the local ethical committee approval was received. 24 patients who were treated with ERAS program were assigned into the ERAS group and 14 patients receiving traditional therapy were allocated in the traditional group. The perioperative conditions were statistically compared between two groups by t test. The rate comparison was performed by Chi-square test or Fisher's exact test.

Results

The postoperative off-bed ambulation time, postoperative exhaust time and postoperative removal time of drainage tube in the ERAS group were (1.5±0.4), (1.4±0.6) and (6.4±1.1) d, significantly shorter than (3.4±0.6), (2.6±0.5) and (8.2±1.3) d in the traditional group (t=-2.56, -3.91, -2.75; P<0.05). In the ERAS group, the operation time and intraoperative blood loss were (132±25) min and (240±30) ml, which did not significantly differ from (26±21) min and (191±15) ml in the traditional group (t=0.68, 0.80; P>0.05). In the ERAS group, 2 cases were converted to open surgery and none in the traditional group, where no significant difference was observed (P>0.05). The incidence of postoperative complications in the ERAS and traditional groups was 17% (4/24) and 14% (2/14), respectively, where no significant difference was observed (χ2=0.846, P>0.05). During the follow-up, no recurrence, peritoneal effusion or major cardiovascular and cerebrovascular complication occurred.

Conclusions

ERAS is an efficacious approach for laparoscopic radical resection of hepatic cystic echinococcosis, which can accelerate postoperative recovery and shorten the length of hospital stay without increasing the surgical risk and postoperative complications.

Key words: Echinococcosis, hepatic, Enhanced recovery after surgery, Hepatectomy, Laparoscopes

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