21th Century Perioperative Surgical Care: Enhanced Recovery After Surgery (ERAS)

黄建宏

21th Century Perioperative Surgical Care: Enhanced Recovery After Surgery (ERAS)

Enhanced recovery After Surgery (ERAS) is a multimodal evidence-based  program of multidisciplinary perioperative surgical care. The goal of ERAS is to accelerate the recovery of surgical patients while decreasing complications and reducing hospital length of stay. Enhanced recovery after surgery is the 21th century perioperative surgical care model. In the United Kingdom, ERAS protocols are adapted as standard management of perioperative care.

The underlying principle of ERAS is to enable patients to recover from surgery and leave hospital sooner by minimizing the stress responses on the body during surgery.
It is essential that  the patient is in the best possible preoperative condition for surgery, receives the best possible intraoperative management,  experiences the best post-operative recovery.

ERAS replaced the traditional perioperative surgical care with evidence-based best practices. ERAS is comprehensive in covering all areas of patient's journey through the whole surgical process (surgeon office, preadmission testing, preop, intraop, postop, post discharge). ERAS provides guidance to all involved in patient centered perioperative care, and helps them to work as a well-coordinated team to provide the best care.   

Key elements of ERAS include: preoperative patient education, reduction of preoperative fasting, omission of bowel preparation, goal-directed fluid management, reduction in perioperative use of nasogastric tubes and drains, early removal of Foley catheters, multimodal analgesia to minimize opiate consumption, early postoperative mobilization, and early oral nutrition.

It has already been shown to benefit patients undergoing colorectal, urological, gynecological, orthopedic, and vascular surgery.  A growing body of evidence including randomized controlled trials has shown that ERAS speeds recovery, reduced length of stay by more than 30%,  reduced postoperative complications by up to 50% (1),  reduces cost while maintaining patient satisfaction and quality of life.  

ERAS is the best  perioperative surgical care model, because ERAS can  achieve result on three dimensions of the Triple Aim: better health care, better patient experience, and lower cost.   

(1) Varandhan, KK et al.  Clin. Nutr 2010

黄建宏

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cxf_80

21世纪围术期外科治疗：术后加快恢复

Enhanced recovery After Surgery (ERAS) is a multimodal evidence-based  program of multidisciplinary perioperative surgical care. The goal of ERAS is to accelerate the recovery of surgical patients while decreasing complications and reducing hospital length of stay. Enhanced recovery after surgery is the 21th century perioperative surgical care model. In the United Kingdom, ERAS protocols are adapted as standard management of perioperative care.
术后加快恢复(ERAS)是多学科领域围术期外科治疗的一个多模式循证项目。ERAS的目标是加快手术病人恢复的同时减少并发症及缩短住院天数。术后加快恢复是21世纪围术期外科治疗的模式。在英国，术后加快恢复方案被（编写）列为围术期治疗的标准管理。
The underlying principle of ERAS is to enable patients to recover from surgery and leave hospital sooner by minimizing the stress responses on the body during surgery.
术后加快恢复(ERAS)的基本原则是通过使手术期间身体的应激反应最小化，让患者较快地从手术中恢复及离院。
It is essential that  the patient is in the best possible preoperative condition for surgery, receives the best possible intraoperative management,  experiences the best post-operative recovery.
最根本的是患者手术前处于较好的术前状态，接受最佳的术中管理，接受术后最佳的康复治疗。

ERAS replaced the traditional perioperative surgical care with evidence-based best practices. ERAS is comprehensive in covering all areas of patient's journey through the whole surgical process (surgeon office, preadmission testing, preop, intraop, postop, post discharge). ERAS provides guidance to all involved in patient centered perioperative care, and helps them to work as a well-coordinated team to provide the best care.   
术后加快恢复(ERAS)通过循证实践取代了传统围术期外科治疗。术后加快恢复(ERAS)包含十分广泛，覆盖了整个外科手术期间病人的各个方面。（手术室，住院前检查，术前，术中，术后，出院后）。术后加快恢复(ERAS)给所有涉及围术期患者治疗的人员提供了指南，并帮助他们协调统一，更好地为患者服务。
Key elements of ERAS include: preoperative patient education, reduction of preoperative fasting, omission of bowel preparation, goal-directed fluid management, reduction in perioperative use of nasogastric tubes and drains, early removal of Foley catheters, multimodal analgesia to minimize opiate consumption, early postoperative mobilization, and early oral nutrition. 术后加快恢复(ERAS)的关键元素包括：术前患者健康教育，缩短术前禁食的时间，省略术前肠道准备，目标导向液体管理，围术期胃管和引流管的减少使用，较早拔除尿管，术中多种方式麻醉以减少阿片类药物的用量，术后早期活动及术后尽早恢复饮食。

It has already been shown to benefit patients undergoing colorectal, urological, gynecological, orthopedic, and vascular surgery.  A growing body of evidence including randomized controlled trials has shown that ERAS speeds recovery, reduced length of stay by more than 30%,  reduced postoperative complications by up to 50% (1),  reduces cost while maintaining patient satisfaction and quality of life.  
现已表明术后加快恢复(ERAS)对实施结直肠、泌尿系、妇科、整形外科、血管外科手术的患者有利。一系列证据，包括随机对照实验表明：术后加快恢复(ERAS)可加速恢复，使住院天数缩短了30%，术后并发症下降达50%，在保证了病人满意度和生活质量的同时降低住院费用。

ERAS is the best  perioperative surgical care model, because ERAS can  achieve result on three dimensions of the Triple Aim: better health care, better patient experience, and lower cost.   
术后加快恢复(ERAS)是最佳的围术期外科诊疗模式，因为术后加快恢复(ERAS)可以在实现三个目标的三个方面：更好的健康保健，更愉快的住院经历，及降低医疗费用。

cxf_80

睡前一浏览才发现这个帖子，翻得比较匆忙，不当之处请朋友们指出，别想请教两个问题，
我有两个地方觉得自己翻译起来不好把握：
1、Enhanced recovery After Surgery (ERAS) 这个翻得太直白了，专业点的该怎么说。
2、文中的care翻译成'什么合适，“治疗”？保健？医疗服务？

黄建宏

Thank cxf_80 for the translation. cxf_80 did a great job.
here is some suggestions:
enhanced recovery after surgery may be better translated to: 增强术后康复
enhanced recovery after surgery begins at surgeon office (外科医生的诊所), not (手术室)

Again, Thanks.
黄建宏

hb116116

前几天我在课题汇报的时候把ERAS翻译成“增强型术后恢复外科”，老是觉得这样翻译欠妥，但是如果按照Fast Track Surgery翻译成“快通道手术”感觉也欠妥，不知道还有没有更好的翻译方法。

黄建宏

21世纪围术期外科治疗：增强术后康复

Enhanced recovery After Surgery (ERAS) is a multimodal evidence-based  program of multidisciplinary perioperative surgical care. The goal of ERAS is to accelerate the recovery of surgical patients while decreasing complications and reducing hospital length of stay. Enhanced recovery after surgery is the 21th century perioperative surgical care model. In the United Kingdom, ERAS protocols are adapted as standard management of perioperative care.
增强术后康复(ERAS)是多学科领域围术期外科治疗的一个多模式循证项目。ERAS的目标是加快手术病人恢复的同时减少并发症及缩短住院天数。增强术后康复
是21世纪围术期外科治疗的模式。在英国，增强术后康复方案被（编写）列为围术期治疗的标准管理。
The underlying principle of ERAS is to enable patients to recover from surgery and leave hospital sooner by minimizing the stress responses on the body during surgery.
增强术后康复(ERAS)的基本原则是通过使手术期间身体的应激反应最小化，让患者较快地从手术中恢复及离院。
It is essential that  the patient is in the best possible preoperative condition for surgery, receives the best possible intraoperative management,  experiences the best post-operative recovery.
最根本的是患者手术前处于较好的术前状态，接受最佳的术中管理，接受术后最佳的康复治疗。

ERAS replaced the traditional perioperative surgical care with evidence-based best practices. ERAS is comprehensive in covering all areas of patient's journey through the whole surgical process (surgeon office, preadmission testing, preop, intraop, postop, post discharge). ERAS provides guidance to all involved in patient centered perioperative care, and helps them to work as a well-coordinated team to provide the best care.   
增强术后康复(ERAS)通过循证实践取代了传统围术期外科治疗。增强术后康复(ERAS)包含十分广泛，覆盖了整个外科手术期间病人的各个方面。（外科医生的诊所，住院前检查，术前，术中，术后，出院后）。增强术后康复(ERAS)给所有涉及围术期患者治疗的人员提供了指南，并帮助他们协调统一，为患者提供最佳服务。
Key elements of ERAS include: preoperative patient education, reduction of preoperative fasting, omission of bowel preparation, goal-directed fluid management, reduction in perioperative use of nasogastric tubes and drains, early removal of Foley catheters, multimodal analgesia to minimize opiate consumption, early postoperative mobilization, and early oral nutrition. 增强术后康复
(ERAS)的关键元素包括：术前患者健康教育，缩短术前禁食的时间，省略术前肠道准备，目标导向液体管理，围术期胃管和引流管的减少使用，较早拔除尿管，术中多种方式麻醉以减少阿片类药物的用量，术后早期活动及术后尽早恢复饮食。

It has already been shown to benefit patients undergoing colorectal, urological, gynecological, orthopedic, and vascular surgery.  A growing body of evidence including randomized controlled trials has shown that ERAS speeds recovery, reduced length of stay by more than 30%,  reduced postoperative complications by up to 50% (1),  reduces cost while maintaining patient satisfaction and quality of life.  
现已表明增强术后康复(ERAS)对实施结直肠、泌尿系、妇科、整形外科、血管外科手术的患者有利。一系列证据，包括随机对照实验表明：增强术后康复
(ERAS)可加速恢复，使住院天数缩短了30%，术后并发症下降达50%，在保证了病人满意度和生活质量的同时降低住院费用。

ERAS is the best  perioperative surgical care model, because ERAS can  achieve result on three dimensions of the Triple Aim: better health care, better patient experience, and lower cost.   
增强术后康复(ERAS)是最佳的围术期外科诊疗模式，因为术后加快恢复(ERAS)可以在实现三个目标：更好的健康保健，更愉快的住院经历，及降低医疗费用。

nashchen

Mark for reading later

yjshiwen

21th Century Perioperative Surgical Care: Enhanced Recovery After Surgery (ERAS)
21世纪围手术期的外科治疗：加强术后康复
Enhanced recovery After Surgery (ERAS) is a multimodal evidence-based  program of multidisciplinary perioperative surgical care. The goal of ERAS is to accelerate the recovery of surgical patients while decreasing complications and reducing hospital length of stay. Enhanced recovery after surgery is the 21th century perioperative surgical care model. In the United Kingdom, ERAS protocols are adapted as standard management of perioperative care.
加强术后康复（ERAS）是指：一种以证据为基础的多模式、多原则围术期外科治疗。ERAS的目标是以加快术后康复同时又降低术后并发症及术后住院天数，它是21世纪围术期的外科治疗模式。在英国，ERAS是标准的围术期治疗方案。
The underlying principle of ERAS is to enable patients to recover from surgery and leave hospital sooner by minimizing the stress responses on the body during surgery.
It is essential that  the patient is in the best possible preoperative condition for surgery, receives the best possible intraoperative management,  experiences the best post-operative recovery.
ERAS的基本原则是在确保患者能从手术后康复基础上，尽可能使患者手术过程中产生最小的应激反应，术后尽快出院。它的关键要素有：患者术前尽可能达到最佳的术前条件，术中尽可能接受最佳的术中管理，术后受受最佳的康复训练。
ERAS replaced the traditional perioperative surgical care with evidence-based best practices. ERAS is comprehensive in covering all areas of patient's journey through the whole surgical process (surgeon office, preadmission testing, preop, intraop, postop, post discharge). ERAS provides guidance to all involved in patient centered perioperative care, and helps them to work as a well-coordinated team to provide the best car

eming0092

术后快速康复外科

Pumchzhubin

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Pumchzhubin

上面我以前讲课时，课件里关于“ERAS”的三张幻灯截图。