Objective: To explore the feasibility of enhanced recovery after surgery (ERAS) in treatment of children with congenital choledochal cyst.
Methods: One hundred and thirty children with congenital choledochal cysts admitted in the Children's Hospital of Zhejiang University from June 2017 to June 2019 were divided into ERAS group (n=65) and control group (n=65) according to admission order. The intestinal tract condition during operation, time of operation, surgical results, time for eating after operation, abdominal drainage after operation, length of hospital stay after operation, total hospital expenses and complications were compared between two groups.
Results: Compared with the control group, the satisfaction of intestinal operation field, recovery of gastrointestinal function after operation,time required for the volume of peritoneal drainage fluid to be less than 50 mL,time of abdominal drainage tube removal, and length of hospital stay were all improved in ERAS group (P<0.05 or P<0.01).ERAS group had more peritoneal effusion after removal of abdominal drainage tube (P<0.01), but the incidence of edema after operation was lower (P<0.05). The satisfaction of parents in the two groups was similar, but the cooperation of parents in the ERAS group was improved (P<0.05) and the total cost of hospitalization was reduced (P<0.01).
Conclusions: ERAS has advantages over the traditional scheme and can be used in the clinical treatment of children with congenital choledochal cyst.
目的: 探讨加速康复外科（ERAS）理念应用于儿童先天性胆总管囊肿围手术期管理中的可行性。
方法: 将浙江大学医学院附属儿童医院2017年6月至2019年6月收治的先天性胆总管囊肿患儿设为队列目标人群，按入院顺序纳入ERAS组和对照组，各65例。分别在术前准备、术中麻醉管理、术后管理三个阶段观察ERAS组和对照组术中肠道情况、手术所需时间、术后差异操作结果、术后开始进食时间、术后腹腔引流液、术后住院时间、住院总费用、术后并发症等情况。
结果: 与对照组比较，ERAS组术中肠道情况满意度，术后胃肠功能恢复时间、腹腔引流液量少于50 mL所需时间、腹腔引流管拔除时间和住院时长均有所改善（ P < 0.05或 P < 0.01）；ERAS组拔除腹腔引流管后腹腔积液量多（ P < 0.01），但术后浮肿发生率低（ P < 0.05）；两组家长满意度相近（ P>0.05），但ERAS组家长配合度提高（ P < 0.05），住院总费用降低（ P < 0.01）。
结论: ERAS理念应用于儿童先天性胆总管囊肿临床治疗具有一定的优势。