Status quo of enhanced recovery after surgery in different regional thoracic surgery in the mainland of China_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHENG E , SHEN Cheng , WANG Wei ,  CHE Guowei , YANG Mei , GUO Chenglin , LIU Lunxu

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding?author：

CHE Guowei, Email: chebenben2005@163.com

Keywords：

Enhanced recovery after surgery; thoracic surgery; region; survey questionnaire

DOI：

10.7507/1007-4848.201708026

Video：

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Objective To analyze the current status and difficulties of ERAS applicated in thoracic surgery in different regional hospitals. Methods A total of 773 valid questionnaires were collected during the First West China Forum on Chest ERAS and analyzed by geographical distribution. The content of the questionnaire was divided into two parts, including the respondents’ institute and personal information, as well as 10 questions about ERAS. Results There were 83.57%, 83.82%, 89.58%, 93.75%, 94.74% and 92.86% of surgeons and nurses in Sichuan province, municipalities, the eastern, western, southern and northern respectively who believed that ERAS in all surgeries should be used. There were 61.84%, 60.29%, 65.97%, 81.25%, 73.68% and 75.00% of surgeons and nurses who thought that the concept of ERAS was more in the theory than in the practice; 77.99%, 80.88%, 74.31%, 78.13%, 83.33% and 69.64% of respondents agreed that average hospital stay, patients’ experience and social satisfaction should be the evaluation standard of ERAS practice while 58.50%, 63.24%, 54.86%, 62.50%, 70.18% and 58.93% of respondents believed that immature procedure, lack of consensus and specifications and insecurity for doctors were the reasons for poor compliance of ERAS; 63.23%, 67.65%, 59.72%, 68.75%, 72.81% and 67.86% of respondents thought that the best team of ERAS should be based on the combination of subject integration, surgery orientation and surgeon-nurse teamwork; 43.73%, 44.12%, 43.75%, 46.88%, 59.65% and 41.07% of respondents thought that multidisciplinary cooperation, multi-modality conducted and surgical programming should be the best way for ERAS implementation; 72.98%, 69.12%, 62.50%, 65.63%, 80.70% and 55.36% of responders agreed that the ERAS forum or conference should include the norms and consensus, analysis and implementation of projects and the status and progress of ERAS. Conclusion There are more consistent views on the clinical application of ERAS in all regions. The subject integration, surgeon-nurse teamwork and multidisciplinary, multi-modality cooperation are the best team and best way for ERAS program implementation.

Citation： ZHENG E, SHEN Cheng, WANG Wei, CHE Guowei, YANG Mei, GUO Chenglin, LIU Lunxu. Status quo of enhanced recovery after surgery in different regional thoracic surgery in the mainland of China. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(8): 681-686. doi: 10.7507/1007-4848.201708026 Copy

1.	Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
2.	Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284): 473-476.
3.	車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.
4.	車國衛, 劉倫旭, 周清華. 加速康復外科從理念到實踐——我們還需要做什么? 中國肺癌雜志, 2017, 20(4): 219-225.
5.	中華醫學會腸外腸內營養學會分會, 加速康復外科協組. 結直腸手術應用加速康復外科中國專家共識(2015版). 中華消化外科雜志, 2015, 14(8): 606-608.
6.	車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
7.	Taniguchi H, Sasaki T, Fujita H, et al. Modified ERAS protocol using preoperative oral rehydration therapy: outcomes and issues. J Anesth, 2014, 28(1): 143-147.
8.	黎介壽, 江志偉. 加速康復外科的臨床意義不僅僅是縮短住院日. 中華消化外科雜志, 2015, 14(1): 22-24.
9.	Hasenberg T, Keese M, Langle F, et al. 'Fast-track' colonic surgery in Austria and Germany-results from the survey on patterns in current perioperative practice. Colorectal Dis, 2009, 11(2): 162-167.
10.	Ahmed J, Khan S, Gatt M, et al. Compliance with enhanced recovery programmes in elective colorectal surgery. Br J Surg, 2010, 97(5): 754-758.
11.	Ahmed J, Khan S, Lim M, et al. Enhanced recovery after surgery protocols-compliance and variations in practice during routine colorectal surgery. Colorectal Dis, 2012, 14(9): 1045-1051.
12.	Hammond JS, Humphries S, Simson N, et al. Adherence to enhanced recovery after surgery protocols across a high-volume gastrointestinal surgical service. Dig Surg, 2014, 31(2): 117-122.
13.	Smart NJ, White P, Allison AS, et al. Deviation and failure of enhanced recovery after surgery following laparoscopic colorectal surgery: early prediction model. Colorectal Dis, 2012, 14(10): e727-e734.
14.	de Groot JJ, Maessen JM, Slangen BF, et al. A stepped strategy that aims at the nationwide implementation of the enhanced recovery after surgery programme in major gynaecological surgery: study protocol of a cluster randomised controlled trial. Implement Sci, 2015, 30(10): 106.
15.	楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后 16F 較 28F 胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
16.	李光焰, 杜娟, 劉寶華, 等. 結直腸癌圍術期醫護一體化快速康復理念的研究. 重慶醫學, 2016, 45(5):619-621.
17.	杜娜, 郭成林, 楊梅, 等. 加速康復外科在中國大陸胸外科臨床現狀——基于胸外科醫生及護士調查分析. 中國肺癌雜志, 2017, 20(3): 157-162.

1. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
2. Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284): 473-476.
3. 車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.
4. 車國衛, 劉倫旭, 周清華. 加速康復外科從理念到實踐——我們還需要做什么? 中國肺癌雜志, 2017, 20(4): 219-225.
5. 中華醫學會腸外腸內營養學會分會, 加速康復外科協組. 結直腸手術應用加速康復外科中國專家共識(2015版). 中華消化外科雜志, 2015, 14(8): 606-608.
6. 車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
7. Taniguchi H, Sasaki T, Fujita H, et al. Modified ERAS protocol using preoperative oral rehydration therapy: outcomes and issues. J Anesth, 2014, 28(1): 143-147.
8. 黎介壽, 江志偉. 加速康復外科的臨床意義不僅僅是縮短住院日. 中華消化外科雜志, 2015, 14(1): 22-24.
9. Hasenberg T, Keese M, Langle F, et al. 'Fast-track' colonic surgery in Austria and Germany-results from the survey on patterns in current perioperative practice. Colorectal Dis, 2009, 11(2): 162-167.
10. Ahmed J, Khan S, Gatt M, et al. Compliance with enhanced recovery programmes in elective colorectal surgery. Br J Surg, 2010, 97(5): 754-758.
11. Ahmed J, Khan S, Lim M, et al. Enhanced recovery after surgery protocols-compliance and variations in practice during routine colorectal surgery. Colorectal Dis, 2012, 14(9): 1045-1051.
12. Hammond JS, Humphries S, Simson N, et al. Adherence to enhanced recovery after surgery protocols across a high-volume gastrointestinal surgical service. Dig Surg, 2014, 31(2): 117-122.
13. Smart NJ, White P, Allison AS, et al. Deviation and failure of enhanced recovery after surgery following laparoscopic colorectal surgery: early prediction model. Colorectal Dis, 2012, 14(10): e727-e734.
14. de Groot JJ, Maessen JM, Slangen BF, et al. A stepped strategy that aims at the nationwide implementation of the enhanced recovery after surgery programme in major gynaecological surgery: study protocol of a cluster randomised controlled trial. Implement Sci, 2015, 30(10): 106.
15. 楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后 16F 較 28F 胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
16. 李光焰, 杜娟, 劉寶華, 等. 結直腸癌圍術期醫護一體化快速康復理念的研究. 重慶醫學, 2016, 45(5):619-621.
17. 杜娜, 郭成林, 楊梅, 等. 加速康復外科在中國大陸胸外科臨床現狀——基于胸外科醫生及護士調查分析. 中國肺癌雜志, 2017, 20(3): 157-162.

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Status quo of enhanced recovery after surgery in different regional thoracic surgery in the mainland of China

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