Application of enhanced recovery after surgery concept in perioperative management of traumatic hepatic rupture

Objective To investigate the application value of enhanced recovery after surgery (ERAS) concept in perioperative period of traumatic hepatic rupture. Methods Clinical data of 41 patients with traumatic hepatic rupture who were admitted to the 113rd Hospital of People's Liberation Army of Anhui Medical University between August 2008 and December 2016 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the treatment methods, the patients were divided into the ERAS group (n=22) and control group (n=19). In the ERAS group, 15 cases were male and 7 were female, aged (43±16) years old on average. In the control group, 14 cases were male and 5 were female, aged (45±17) years old on average. The postoperative recovery time of gastrointestinal function, hospital stay, hospitalization expenses and postoperative C-reactive protein (CRP) level between both groups were compared by t test. Results The postoperative recovery time of gastrointestinal function, hospital stay and hospitalization expenses was respectively (2.8±0.7) d, (6.5±1.5) d and (3.7±1.3)×104 yuan in the ERAS group, significantly less than (3.3±0.5) d, (8.5±1.5) d and (5.8±1.1)×104 yuan in the control group (t=-2.507, -3.935, -5.806; P<0.05). The postoperative 1, 3 d CRP level was respectively (81±16) and (25±10) mg/L in the ERAS group, significantly lower than (93±19) and (36±8) mg/L in the control group (t=-2.123, -4.151; P<0.05). Conclusions Application of ERAS measures can effectively control the inflammatory reaction, shorten the recovery time of gastrointestinal function and hospital stay, reduce hospitalization expenses and promote rapid rehabilitation of patients. Key words: Enhanced recovery after surgery; Wounds and injuries; Liver; Perioperative care