婦癌手術前後的標準照護(II)

Enhanced Recovery After Surgery as a New Standard of Care in Perioperative Gynecologic Oncology Partice – Part II

手術過程中會對組織造成傷害，主要分直接傷害（如切割、灼燒、汽化、牽扯等）及間接傷害（如局部灌流減少、影響氧氣和營養的給予不足）。手術前、後的處理如能遵循手術後加速復原的方法，可降低手術壓力、代謝反應和併發症，改善手術後功能恢復與結果。婦癌患者手術後快速復原方法，已被英國和德國許多醫學中心所採用。本文特說明手術後快速復原方法的各項步驟，以供婦產科同仁參考。

Primary cellular injury during perioperative surgery can be caused by direct surgical injury (from trauma, heating, vaporization, traction, etc.) or indirect injury from changes in local perfusion, impairing oxygen and nutrient delivery. Now, the development of enhanced recovery after surgery (ERAS)— with the aim of reducing stress response, metabolic response and complications—improves postoperative function and outcome. The spread and adoption of ERAS have been rapid and many centers in the United Kingdom and Germany now have ERAS in gynecological surgery. The recommendations of ERAS for postoperative management of patients undergoing gynecologic oncology surgery are discussed in this article.