Application of enhanced recovery after surgery in adrenal and renal tumor operation

Abstract:

Objective：To evaluate the effect of enhanced recovery after surgery（ERAS） on adrenal and renal tumor operation. Methods：The patients with adrenal tumor or renal tumor treated by the proposed surgery in our hospital from March 2017 to February 2018 were randomly divided into ERAS group and routine group by random number table method. According to preset inclusion and exclusion criteria，89 cases were in ERAS group，including 38 cases of adrenal tumor，15 cases of kidney cancer and 36 cases of renal cyst，100 cases were in the routine group，including 49 cases of adrenal tumor，16 cases of kidney cancer and 35 cases of renal cyst. The ERAS group was treated by preset ERAS measures and was compared with the routine group by perioperative indicators. Results：Compared with those of routine group，postoperation first drinking time[（3.1±1.7） h vs. （7.8±3.5） h，t′= -11.419，P＝0.00０]，postoperation first eating time[（7.6±3.7） h vs. （13.0±6.9） h，t′=-6.611，P＝0.00０] and postoperation first off-bed ambulation time[（9.1±4.9） h vs. （26.9±16.3） h，t′=-10.449，P＝0.00０） in ERAS group were earlier；postopertion placing urinary catheter time[（10.1±4.5） h vs. （23.2±15.4） h，t=-8.165，P＝0.00０]，postoperative anal exhaust time[（10.0±7.6） h vs. （15.0±9.0） h，t′=-4.157，P＝0.00０] and postoperative hospitalization days[（2.7±1.8） d vs. （3.6±2.1） d，t′=－３.128，P=0.002] were significantly shorter in ERAS group；postoperative 2 h VAS pain score[（3.3±0.8） vs. （4.3±0.8），t=-8.925，P＝0.00０] and postoperation first off-bed ambulation VAS pain score[（2.5±0.6） vs. （3.4±0.7），t=-8.662，P＝0.00０] were lower in ERAS group. There was no significantly statistical difference in operation time[（55.8±32.5） min vs. （58.5±31.8） min，t′=-0.557，P=0.578]，bleeding[（48.2±39.2） mL vs. （48.3±34.6） mL，t′=－0.008，P=0.994]，postoperative compli－cations（3/89 vs. 6/100， ?字2=0.712，P=0.398） and drainage tube retention time between two groups[（24.4±16.2） h vs. （27.0±15.3） h，t′=－1.１４３，P=0.255]. Conclusion： The application of the ERAS concept is safe and effective in perioperative period of adrenal and kidney turnor surgery，which can significantly accelerate postoperative rehabilitation，improve patient’s comfort and shorten hospital stay.