关键词: 安全性 , 加速康复外科, 胃十二指肠穿孔, 有效性

Abstract: 【Abstract】 Objective The aim of this study was to assess the feasibility and safety of laparoscopic surgery for gastric and duodenal perforation within enhanced recovery after surgery （ERAS） programs. Methods In this retrospective analysis conducted between January 2014 and May 2016，88 consecutive patients diagnosed with gastric and duodenal perforation following laparoscopic surgery were allocated to either ERAS group（N=42）or conventional pathway group（N=46）. The complication，postoperative gastrointestinal function, hospital stay, cost and compliance were evaluated between two groups. Results There were no significant distribution differences of demographics and surgical time between two groups（P>0.05）. Moreover，the incidences of postoperative complication rate were similar between ERAS group and conventional group （9.5% vs 10.9%, P=0.835）. Gastrointestinal recovery parameters such as time to the first flatus（1.8 d vs 2.0 d，P=0.011）and time to the first defecation（2.2 d vs 2.5 d, P=0.018）occurred earlier in ERAS group. The post hospital stay（days）in ERAS and the conventional group were 6.9 d and 7.8 d（P=0.003） respectively. Moreover, the cost （yuan） in the ERAS group was reduced compared to the conventional group （8661.4 vs 9325.7, P=0.044）. In additional, cases in the ERAS group had a shorter stay of gastric tube, abdominal drainage tube and urethral catheter （P<0.05）. Conclusion This study appeared to the feasibility and safety of ERAS protocol in patients with gastric and duodenal perforation undergoing laparoscopic surgery and was associated with a great improvement in postoperative recovery，shorter duration of hospital stay and less cost.

Key words: enhanced recovery after surgery, gastric and duodenal perforation, feasibility, Safety