临床小儿外科杂志2024，Vol.23Issue(10)：924-928,5.DOI:10.3760/cma.j.cn101785-202402013-005
日间手术管理模式在儿童机器人动脉导管结扎术中的应用
Application of Enhanced Recovery Surgery in Pediatric Robotic Arteriosus Catheter Ligation Day Surgery
摘要
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,sur-gery 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 can-cellation 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 ap-plication 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 experi-ence for children and their parents and does not increase the incidence of postoperative complications,making it a safe and feasible approach in clinical practice.关键词
加速康复外科/机器人手术/日间手术/动脉导管未闭/儿童Key words
Enhanced Recovery After Surgery/Robotic Surgical Procedures/Day Surgery/Patent Ductus Arteriosus/Child引用本文复制引用
赵杭燕,刘喜旺,应力阳,林彬洁,章何莹,舒强..日间手术管理模式在儿童机器人动脉导管结扎术中的应用[J].临床小儿外科杂志,2024,23(10):924-928,5.基金项目
浙江省中医药科技计划项目(2023ZL499) Zhejiang Province Traditional Chinese Medicine Science and Technology Program(2023ZL499) （2023ZL499）
