Implementation of the pre-operative rehabilitation recovery protocol and its effect on the quality of recovery after colorectal surgeries  

作　　者：Li-Hua Peng Wen-Jian Wang Jing Chen Ju-Ying Jin Su Min Pei-Pei Qin 

机构地区：[1]The Department of Anesthesia and Pain Medicine,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China

出　　处：《Chinese Medical Journal》2021年第23期2865-2873,共9页中华医学杂志（英文版）

基　　金：the National Clinical Key Discipline Project,the co-grant of Health Bureau of Chongqing Municipality and Chongqing Association for Science and Technology(No.2020MSXM042);technology promotion project of the Health Bureau of Chongqing Municipality(2020jstg026).

摘　　要：Background:Patients’recovery after surgery is the major concern for all perioperative clinicians.This study aims to minimize the side effects of peri-operative surgical stress and accelerate patients’recovery of gastrointestinal(GI)function and quality of life after colorectal surgeries,an enhanced recovery protocol based on pre-operative rehabilitation was implemented and its effect was explored.Methods:A prospective randomized controlled clinical trial was conducted,patients were recruited from January 2018 to September 2019 in this study.Patients scheduled for elective colorectal surgeries were randomly allocated to receive either standardized enhanced recovery after surgery(S-ERAS)group or enhanced recovery after surgery based on pre-operative rehabilitation(group PR-ERAS).In the group PR-ERAS,on top of recommended peri-operative strategies for enhanced recovery,formatted rehabilitation exercises pre-operatively were carried out.The primary outcome was the quality of GI recovery measured with I-FEED scoring.Secondary outcomes were quality of life scores and strength of handgrip;the incidence of adverse events till 30 days post-operatively was also analyzed.Results:A total of 240 patients were scrutinized and 213 eligible patients were enrolled,who were randomly allocated to the group S-ERAS(n=104)and group PR-ERAS(n=109).The percentage of normal recovery graded by I-FEED scoring was higher in group PR-ERAS(79.0%vs.64.3%,P<0.050).The subscores of life ability and physical well-being at post-operative 72 h were significantly improved in the group PR-ERAS using quality of recovery score(QOR-40)questionnaire(P<0.050).The strength of hand grip post-operatively was also improved in the group PR-ERAS(P<0.050).The incidence of bowel-related and other adverse events was similar in both groups till 30 days post-operatively(P>0.050).Conclusions:Peri-operative rehabilitation exercise might be another benevolent factor for early recovery of GI function and life of quality after colorectal surgery.Newer,more surgery-sp

关 键 词：Enhanced recovery after surgery Gastrointestinal function Peri-operatively REHABILITATION 

分 类 号：R735.34[医药卫生—肿瘤]