| ObjectiveTo investigate the clinical effect,economics and application of Enhanced Recovery After Surgery(ERAS)in 1470 nm diode laser vaporesection of the prostate,and its safety and effectiveness in elderly patients with benign prostatic hyperplasia.MethodsWe retrospectively analyzed 141 cases of 1470 nm diode laser vaporesection of the prostate in the first ward of the First Affiliated Hospital of Nanhua University from January 2018 to November 2019.The operations were performed by the same chief physician.According to whether the ERAS protocol was adopted during the perioperative period,it was divided into the ERAS group(69 cases)and the traditional group(72 cases).36 patients aged 70 years or older in the ERAS group were included in the ERAS elderly group,and 34 patients in the traditional group were aged 70 Patients were included in the traditional elderly group.Postoperative anal exhaust time,visual pain score,bladder continuous irrigation time,catheter indwelling time,incidence of complications,postoperative hospitalization time,total hospitalization cost and rehospitalization rate within 1 month after discharge were compared.T-test was used for the comparison of measurement data with normal distribution,rank sum test was used for the comparison of measurement data with skewness distribution,and chi-square test was used for the comparison of counting data between groups.ResultsComparison between ERAS groups and traditional groups.There were no statistically significant differences in age,prostate volume,serum total prostate-specific antigen,international prostatic symptom score,quality of life score and complications(P >0.05).In the ERAS group,the postoperative first anal exhaust time(9h vs 13 h,P=0.000)was advanced,bladder continuous lavage time(40h vs 44 h,P=0.001),indwelling time(73h vs 90 h,P=0.004),postoperative hospitalization time(4d vs 5d,P=0.002),and the total hospitalization cost(23920±2033 yuan vs 24698±2188 yuan,P=0.031)were reduced.The VAS score of 4 hours after surgery(1 vs 4,P=0.000)in the ERAS group was significantly reduced.There was no statistically significant difference between hemoglobin and sodium concentrations before surgery(P >,0.05),but the postoperative hemoglobin values in the ERAS group(126.64±16.34g/L vs 125.35±13.29g/L,P=0.000)were higher and the serum sodium concentrations(140.59±2.39mmol/L vs 141.56±2.05mmol/L,P= 0.009)were lower.There was no difference in postoperative complications and rehospitalization rate within 1 month after discharge(P >0.05).Comparison of the ERAS elderly group with the traditional elderly group.There was no difference in preoperative basic data(age,PV,IPSS,QOL,TPSA and complications)(P >0.05).The first anal exhaust time(8h vs 14 h,P=0.000),catheter extraction time(78h vs 91 h,P=0.011),bladder continuous irrigation time(39h vs 42 h,P=0.018),postoperative hospitalization time(4d vs 5d,P=0.006),and total hospitalization cost(24102±1783 yuan vs 24976±1641 yuan,P=0.037)were reduced in the ERAS group.The VAS score of 4 hours after surgery(1 vs 4,P=0.000)in the ERAS group was significantly decreased.There was no difference between the two groups in preoperative hemoglobin and serum sodium concentrations(P > 0.05),but the postoperative hemoglobin values(124.20±13.34g/L vs 122.61±10.04g/L,P=0.000)in the ERAS group were higher and the serum sodium concentrations(140.98±2.44mmol/L vs 141.46±1.90mmol/L,P= 0.008)were lower.There was no significant difference in postoperative complications and rehospitalization rate between the two groups(P >0.05).Conclusions1.The application of ERAS in 1470 nm diode laser vaporesection of the prostate can promote the recovery of postoperative gastrointestinal function,shorten the hospitalization time and reduce the hospitalization cost,without increasing the incidence of complications and rehospitalization rate.2.The perioperative period of ERAS in elderly BPH patients is safe and effective. |
PDF Full Text Request