Journal of Capital Medical University ›› 2019, Vol. 40 ›› Issue (1): 78-83.doi: 10.3969/j.issn.1006-7795.2019.01.014

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Application of enhanced recovery after surgery in retroperitoneal laparoscopic upper urinary surgeries

Liu Sai1, Wasilijiang Wahafu1, Niu Yinong1, Gao Jiandong1, Cui Liyan1, Song Liming1, Ping Hao1, Yang Feiya1, Wang Mingshuai1, Xing Nianzeng1,2   

  1. 1. Institute of Urology, Capital Medical University;Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;
    2. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
  • Received:2018-10-24 Online:2019-01-21 Published:2019-01-23
  • Supported by:
    This study was supported by Beijing Municipal Administration of Hospitals "Qingmiao" Talent Training Plan (QML20160303), Beijing Municipal Administration of Hospitals "Dengfeng" Talent Training Plan (DFL20150301).

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Abstract: Objective To compare the efficacy and safety of enhanced recovery after surgery (ERAS) and conventional recovery after surgery (CRAS) in retroperitoneal laparoscopic upper urinary surgeries. Methods From June 2016 to September 2017, 62 cases of retroperitoneal laparoscopic upper urinary surgeries were conducted, in which 33 patients with CRAS between June 2016 and May 2017 and 29 cases with ERAS between May 2017 and September 2017. There were no statistical differences between the two groups in some preoperative parameters, including age, body mass index (BMI), Charlson comorbidity index (CCI), and the American Society of Anesthesiologists (ASA) score. No significant differences were found between the two groups in preoperative laboratory results (P>0.05). The perioperative information and early (30-day) complications of 62 patients were analyzed. Results Twenty-nine patients with ERAS and 33 patients with CRAS were successfully implemented with retroperitoneal laparoscopic upper urinary surgeries. There were significant differences between the two groups in intraoperative crystalloid infusion[1 000(525-1100)mL vs 1 100(1 000-1 350)mL, P=0.027], intraoperative colloid infusion[500(500-500)mL vs 500(500-1 000)mL, P=0.007], duration of gastric tube[0d vs 1(1-1)d, P=0.000], and duration of resumption to normal diet[1(1-2)d vs 2(1-3)d, P=0.023]. No significant differences (P>0.05) was observed between the ERAS and the CRAS group in operative time, estimated blood loss, duration of drainage, postoperative days, and the ratio of surgeries. There were 3 cases (10.3%) and 5 cases (15.2%) of complications in Grade 1 of Clavien-Dindo in the ERAS and CRAS group, respectively. No patients were readmitted to the hospital. Conclusion Compared with CRAS, ERAS can accelerate the resumption to normal diet. The application of ERAS is safe and feasible in retroperitoneal laparoscopic upper urinary surgeries. Randomized controlled trials with large sample size are further needed to evaluate the program comprehensively.

Key words: enhanced recovery after surgery, retroperitoneal laparoscopy, upper urinary surgery

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