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Clinical efficacy of enhanced recovery after surgery in percutaneous nephrolithotripsy: a randomized controlled trial.

ABSTRACT: BACKGROUND:To evaluate the feasibility, safety, applied value and efficacy of enhanced recovery after surgery (ERAS) for PCNL for the treatment of renal calculi. Although the ERAS is applied for many urological diseases, its application in percutaneous nephrolithotripsy (PCNL) is still limited. METHODS:This was a prospective study of patients admitted to hospital January and December 2018 and who were only diagnosed with renal calculi and excepted for serious or uncontrollable basic diseases and patients with multiple operation history and medication history. Patients were randomized 1:1 to the ERAS and traditional operation groups starting on the day before operation and end on the day of discharge. Each group was 118 cases. The stone clearance rate, visual analogue scale (VAS) pain score, the occurrence of perirenal hematoma and effusion, the incidence of extravasation of urine, the incidence of fever, bleeding and blood transfusion, and postoperative hospital stay were observed. RESULTS:The stone clearance rates were similar between the two groups (ERAS: 93.2% (109/117) vs. traditional: 89.8% (106/118), P?=?0.800). The operation time was similar in the two groups (ERAS: 54?±?12 vs. traditional: 58?±?11 min, P?=?0.656). VAS pain score that was 0.79?±?0.76 in the ERAS group at 4 h after surgery and was significantly lower than 2.79?±?0.98 in the traditional group (P?

SUBMITTER: Li Q

PROVIDER: S-EPMC7574411 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Clinical efficacy of enhanced recovery after surgery in percutaneous nephrolithotripsy: a randomized controlled trial.

Li Qing Q Wan Li L Liu Shucheng S Li Mingyong M Chen Libo L Hou Zhengwu Z Zhang Wang W

BMC urology 20201020 1

<h4>Background</h4>To evaluate the feasibility, safety, applied value and efficacy of enhanced recovery after surgery (ERAS) for PCNL for the treatment of renal calculi. Although the ERAS is applied for many urological diseases, its application in percutaneous nephrolithotripsy (PCNL) is still limited.<h4>Methods</h4>This was a prospective study of patients admitted to hospital January and December 2018 and who were only diagnosed with renal calculi and excepted for serious or uncontrollable bas ...[more]

PMID: 33081762

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Project description:BackgroundEnhanced recovery after surgery (ERAS) protocols were rapidly adopted in many surgeries such as fast-track arthroplasty. The study aimed to investigate the impact of ERAS protocols on the clinical effect of total knee arthroplasty (TKA) via the midvastus approach.MethodsA total of 69 patients who underwent primary unilateral TKA via the midvastus approach from October 2018 to June 2019 were enrolled and randomly divided into two groups: ERAS group and Control group. The ERAS protocols were adopted for the ERAS group and consisted of pure juice drinking 2 h before the surgery, optimization of the preoperative anesthesia plan, phased use of tourniquets, and the use of tranexamic acid as well as a drug cocktail. The operative time, first postoperative walking time, first straight leg elevation time, postoperative hospitalization time, visual analogue scale score (VAS score), Hospital for Special Surgery score (HSS score), conventional Knee Society score (KSS), and knee range of motion (ROM) were used to assess the clinical effects in the two groups. All the included patients were followed up for 12 months.ResultsThere were no significant differences in the basic demographic information and operation time between the ERAS and Control groups (P > 0.05). The first postoperative walking time (2.11 ± 0.11 h) and first postoperative straight leg elevation time (6.14 ± 1.73 h) in the ERAS group were significantly earlier than those in the Control group (P < 0.001) and the postoperative hospitalization time was significantly shorter (3.11 ± 0.32 days). The postoperative mean VAS scores in both groups were significantly reduced compared with those before surgery (P < 0.001). The VAS scores for the ERAS group were significantly lower than those for the Control group at 1, 2, and 7 days after surgery (P < 0.001). The mean HSS scores, KSS, and knee ROM were significantly increased in both the ERAS and Control groups at 1, 3, 6, and 12 months after surgery (P < 0.001). In addition, the HSS scores, KSS, and knee ROM in the ERAS group were significantly higher than those in the Control group at 1 month after surgery (P < 0.001).ConclusionsERAS protocols improved the clinical effects of TKA via the midvastus approach, facilitating early out-of-bed activity and comfortable postoperative rehabilitation exercise, and further increasing patient satisfaction.Trial registrationClinicalTrials.gov Identifier: NCT04873544 .

Dataset Information

Clinical efficacy of enhanced recovery after surgery in percutaneous nephrolithotripsy: a randomized controlled trial.

Publications

Clinical efficacy of enhanced recovery after surgery in percutaneous nephrolithotripsy: a randomized controlled trial.

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