[Enhanced recovery program in thoracoabdominal surgery].

Autor:	Shestakov AL; Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russia., Bitarov TT; Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russia., Nikoda VV; Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russia., Boeva IA; Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russia., Tskhovrebov AT; Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russia., Tarasova IA; Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russia., Bezaltynnykh AA; Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russia., Gorshunova AP; Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury [Vopr Kurortol Fizioter Lech Fiz Kult] 2021; Vol. 98 (6. Vyp. 2), pp. 46-52.
DOI:	10.17116/kurort20219806246
Abstrakt:	Significant improvement of treatment outcomes and reduction of postoperative hospital stay can be achieved, provided a multifaceted approach used in the management of patients. The introduction of the enhanced recovery program addressing all possible factors of the perioperative period will contribute to the treatment protocol development for patients after extensive surgery on the esophagus. Objective: To improve medical rehabilitation outcomes in patients after extensive surgery for benign and malignant diseases of the esophagus by implementing an enhanced recovery program. Materials and Methods: Patients with benign and malignant esophageal diseases underwent radical surgical repair under general balanced anesthesia with mechanical ventilation. With the collaboration of surgery, anesthesiology, and intensive care staff, a proprietary day-by-day enhanced recovery program was developed based on existing guidelines for patient management and systematic reviews on the enhanced recovery protocol after surgical esophageal repair. Results: The developed patient management program was effective due to the reduction of intensive care unit stay and the total postoperative stay in all main group patients. The use of minimally invasive video-endoscopic techniques contributed to the reduction of intensive care unit stay. A less severe surgical stress response was observed in patients in the group of thoracoscopic subtotal esophageal resections. Conclusion: The introduction of the enhanced recovery program promotes the reduction of hospital stay and ICU stay in surgical esophageal repair patients. Also, it allows optimizing the postoperative management of patients with complicated and uncomplicated postoperative periods.
Databáze:	MEDLINE
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