Технология ускоренного восстановления после операции: современное состояние в спинальной нейрохирургии

Последнее десятилетие XXI в. ознаменовалось активным развитием и внедрением в клиническую практику технологии ускоренного восстановления после операции (Enhanced Recovery After Surgery, ERAS, или fast track). Она позволяет обеспечить быстрое и качественное восстановление после операции, уменьшить число осложнений, снизить сроки госпитализации и медицинские расходы без увеличения повторных госпитализаций, послеоперационной заболеваемости и необходимости наблюдения в отделении интенсивной терапии, а также минимизировать различия в оказании периоперационной помощи в различных медицинских учреждениях и улучшить качество оказания медицинской помощи населению.

Цель работы – представление истории развития и современного состояния технологии ускоренного восстановления после операции (ERAS), единственного протокола Ассоциации ERAS Society для спинальной хирургии у взрослых и сводного протокола у детей, а также результатов внедрения ERAS в различных разделах спинальной нейрохирургии.

1. Buttner M., Mayer A.M., Buchler B. еt al. Economic analyses of fast-track total hip and knee arthroplasty: a systematic review. Eur J Orthop Surg Traumatol 2020;30(1):67–74. DOI: 10.1007/s00590-019-02540-1

2. Cao Y, Gu H.Y., Huang Z.D. et al. Impact of enhanced recovery after surgery on postoperative recovery for pancreaticoduodenectomy: pooled analysis of observational study. Front Oncol 2019;30(9):687. DOI: 10.3389/fonc.2019.00687

3. Brown J.K., Singh K., Dumitru R. et al. The benefits of enhanced recovery after surgery programs and their application in cardiothoracic surgery. Methodist Debakey Cardiovasc J 2018;14(2):77–88. DOI: 10.14797/mdcj-14-2-77

4. Golder H.J., Papalois V. Enhanced recovery after surgery: history, key advancements and developments in transplant surgery. J Clin Med; 2021;10(8):1634. DOI: 10.3390/jcm10081634

5. Olle L. Enhanced recovery after surgery and the ERAS Society. J Pancreatol 2019;2:65–8. DOI: 10.1097/JP9.0000000000000025

6. Zatevachin I.I., Pasechnik I.N. The program of accelerated recovery in surgery (fast trak) has been introduced. What’s the next? Grekov's Bulletin of Surgery 2018;177(3):70–5. DOI: 10.24884/0042-4625-2018-177-3-70-75

7. Ljungqvist O., Young-Fadok T., Demartines N. The history of enhanced recovery after surgery and the ERAS society. J Laparoendosc Adv Surg Tech A 2017;27(9):860–2. DOI: 10.1089/lap.2017.0350

8. George J.A., Koka R., Gan T.J. et al. Review of the enhanced recovery pathway for children: perioperative anesthetic considerations. Can J Anaesth 2018;65(5):569–77. DOI: 10.1007/s12630-017-1042-6

9. Patil S., Cornett E.M., Jesunathadas J.et al. Implementing enhanced recovery pathways to improve surgical outcomes. J Anaesthesiol Clin Pharmacol 2019;35(Suppl 1):S24–8. DOI: 10.4103/joacp.JOACP_36_18

10. Ljungqvist O., Hubner M. Enhanced recovery after surgery-ERASprinciples, practice and feasibility in the elderly. Aging Clin Exp Res;30(3):249-252, Mar 2018, DOI: 10.1007/s40520-018-0905-1

11. Rove K.O., Edney J.C., Brockel M.A. Enhanced recovery after surgery in children: Promising, evidence-based multidisciplinary care. Paediatr Anaesth 2018;28(6):482–92. DOI: 10.1111/pan.13380

12. Licina A., Silvers A., Laughlin H. et al. Proposed pathway for patients undergoing enhanced recovery after spinal surgery: protocol for a systematic review. Syst Rev 2020;9(1):39. DOI: 10.1186/s13643-020-1283-2

13. Venkata H.K., van Dellen J.R. A perspective on the use of an enhanced recovery program in open, non-instrumented day surgery for degenerative lumbar and cervical spinal conditions. J Neurosurg Sci;62(3):245–54, Jun 2018, DOI: 10.23736/S0390-5616.16.03695-X

14. Dietz N., Sharma M., Adams S. et al. Enhanced Recovery After Surgery (ERAS) for spine surgery: a systematic review. World Neurosurg 2019;130:415–26. DOI: 10.1016/j.wneu.2019.06.181

15. Debono B., Sabatier P., Garnault V. et al. Outpalumbar microdiscectomy in france: from an economic imperative to a clinical standard – an observational study of 201 castient es. World Neurosurg 2017;106:891–7. DOI: 10.1016/j.wneu.2017.07.065

16. Debono B., Sabatier P., Garnault V. et al. Consensus statement for perioperative care in lumbar spinal fusion: Enhanced Recovery After Surgery (ERAS) society recommendations. Spine J 2021;21(5):729-52. DOI: 10.1016/j.spinee.2021.01.001

17. Carr D.A., Saigal R., Zhang F. et al. Enhanced perioperative care and decreased cost and length of stay after elective major spinal surgery. Neurosurg Focus 2019;46(4):E5. DOI: 10.3171/2019.1.FOCUS18630

18. Garin C. Enhanced recovery after surgery in pediatric orthopedics (ERAS-PO). Orthop Traumatol Surg Res 2020;106(1S):S101–7. DOI: 10.1016/j.otsr.2019.05.012

19. Ljungqvist O., Scott M., Fearon K.C. Enhanced Recovery After Surgery: A Review. JAMA Surg 2017;152(3):292–8. DOI: 10.1001/jamasurg.2016.4952

20. Ljungqvist O., Thanh N.X., Nelson G. ERAS-Value based surgery. J Surg Oncol 2017;116(5):608–12. DOI: 10.1002/jso.24820

21. Zhang X., Yang J., Chen X. et al. Enhanced recovery after surgery on multiple clinical outcomes: Umbrella review of systematic reviews and meta-analyses. Medicine (Baltimore) 2020;99(29):e20983. DOI: 10.1097/MD.0000000000020983

22. Liu V.X., Rosas E., Hwang J. et al. Enhanced recovery after surgery program implementation in 2 surgical populations in an Integrated Health Care Delivery System. JAMA Surg 2017;152(7):e171032. DOI: 10.1001/jamasurg.2017.1032

23. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 1997;78(5):606–17. DOI: 10.1093/bja/78.5.606

24. Bradshaw B.G., Liu S.S., R.C. Thirlby R.C. Standardized perioperative care protocols and reduced length of stay after colon surgery. J Am Coll Surg 1998;186(5):501–6. DOI: 10.1016/s10727515(98)00078-7

25. Kehlet H., Mogensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. Br J Surg 1999;86(2):227–30. DOI: 10.1046/j.1365-2168.1999.01023.x

26. Maessen J., Dejong C.H., Hausel J.et al. A protocol is not enough to implement an enhanced recovery programme for colorectal resection. Br J Surg 2007;94(2):224–31. DOI: 10.1002/bjs.5468

27. Lassen K., Hannemann P., Ljungqvist O. et al. Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries. BMJ 2005;330(7505):1420–1. DOI: 10.1136/bmj.38478.568067.AE

28. Varadhan K.K., Neal K.R., Dejong C.H. et al. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr 2010;29(4):434–40. DOI: 10.1016/j.clnu.2010.01.004

29. Ljungqvist O. ERAS – enhanced recovery after surgery: moving evidence-based perioperative care to practice. JPEN J Parenter Enteral Nutr 2014;38(5): 559–66. DOI: 10.1177/0148607114523451

30. Gillissen F., Hoff C., Maessen J.M. et al. Structured synchronous implementation of an enhanced recovery program in elective colonic surgery in 33 hospitals in The Netherlands. World J Surg 2013;37(5):1082–93. DOI: 10.1007/s00268-013-1938-4

31. ERAS Compliance Group. The impact of enhanced recovery protocol compliance on elective colorectal cancer resection: results from an International Registry. Ann Surg 2015;261(6):1153–9. DOI: 10.1097/SLA.0000000000001029

32. Gustafsson U.O., Oppelstrup H., Thorell A. et al. Adherence to the ERAS protocol is Associated with 5-year survival after colorectal cancer surgery: a retrospective cohort study. World J Surg 2016;40(7):1741–7. DOI: 10.1007/s00268-016-3460-y

33. Fearon K.C., Ljungqvist O., Von Meyenfeldt M. et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr 2005;24(3):466–77. DOI: 10.1016/j.clnu.2005.02.002

34. Nazarenko A.G., Konovalov N.A., Krut'ko A.V. et al. Postoperative applications of the fast track technology in patients with herniated intervertebral discs of the lumbosacral spine. Zh Vopr Neirokhir Im N.N. Burdenko 2016;80(4):5–12. (In Eng./Russ.). DOI: 10.17116/neiro20168045-12

35. Elias K.M., Stone A.B., Mcgonigle K. et al. The Reporting on ERAS Compliance, Outcomes, and Elements Research (RECOvER) Checklist: A Joint Statement by the ERAS. World J Surg 2019;43(1):1–8. DOI: 10.1007/s00268-018-4753-0

36. Burgess L.C., Arundel J., Wainwright T.W. The effect of preoperative education on psychological, clinical and economic outcomes in elective spinal surgery: a systematic review. Healthcare (Basel) 2019;7(1):48. DOI: 10.3390/healthcare7010048

37. Elsarrag M., Soldozy S., Patel P. et al. Enhanced recovery after spine surgery: a systematic review. Neurosurg Focus 2019;46(4):E3. DOI: 10.3171/2019.1.FOCUS18700

38. Corniola M.V., Debono B., Joswig H. et al. Enhanced recovery after spine surgery: review of the literature. Neurosurg Focus 2019;46(4):E2. DOI: 10.3171/2019.1.FOCUS18657

39. Pennington Z., Cottrill E., Lubelski D. et al. Clinical utility of enhanced recovery after surgery pathways in pediatric spinal deformity surgery: systematic review of the literature. J Neurosurg Pediatr 2020;27(2):225–38. DOI: 10.3171/2020.7.PEDS20444

40. Kalinin A. A., Goloborodko V.Y., Shepelev V.V. et al. Accelerated recovery program for patients with polysegmental degenerative lumbar spine disease. Sovrem Tekhnologii Med 2021;13(2):74–81. DOI: 10.17691/stm2021.13.2.09

41. Сайфуллин А.П., Боков А.Е., Олейник А.Я. и др. Технология ускоренного восстановления в спинальной хирургии у детей и подростков: систематический обзор литературы. Хирургия позвоночника 2021:18(4): 6–27. DOI: 10.14531/ss2021.4.6-27

42. Сайфуллин А. П., Алейник А. Я., Боков А. Е. и др. Технология ускоренного восстановления ERAS в спинальной нейрохирургии: систематический обзор литературы. Нейрохирургия 2022;24(1):83–100. DOI: 10.17650/1683-3295-2021-24-1-83-100

43. Li C., Cheng Y., Li Z. et al. The pertinent literature of enhanced recovery after surgery programs: a bibliometric approach. Medicina (Kaunas) 2021;57(2):172. DOI: 10.3390/medicina57020172

44. Laughlin S.M., Alvarez A., Falcao L.F.D.R., Ljungqvist O. The History of ERAS (Enhanced Recovery After Surgery) Society and its development in Latin America. Rev Col Bras Cir 2020 Jun 3;47:e20202525. DOI: 10.1590/0100-6991e-20202525

45. Collaborative C. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg 2020;107(11):1440–9. DOI: 10.1002/bjs.11746

46. Stone R., Scheib S. Advantages of, and adaptations to, enhanced recovery protocols for perioperative care during the COVID-19 pandemic. J Minim Invasive Gynecol 2021;28(3):481–9. DOI: 10.1016/j.jmig.2020.12.024

47. Wainwright T.W., Low M. Beyond acute care: Why collaborative self-management should be an essential part of rehabilitation pathways for COVID-19 patients. J Rehabil Med 2020;52(5):jrm00055. DOI: 10.2340/16501977-2685

48. Wainwright T.W. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS) society recommendations. Acta Orthop 2020;91(3):363. DOI: 10.1080/17453674.2020.1724674

49. Kort N.P., Barrena E.G., Beard M. et al. Resuming elective hip and knee arthroplasty after the first phase of the SARS-CoV-2 pandemic: the European Hip Society and European Knee Associates recommendations. Knee Surg Sports Traumatol Arthrosc 2020;28(9):2730–46. DOI: 10.1007/s00167-020-06233-9

50. Ljungqvist O., Nelson G., Demartines N. The Post COVID-19 Surgical Backlog: Now is the time to implement Enhanced Recovery After Surgery (ERAS). World J Surg 2020;44(10):3197–8. DOI: 10.1007/s00268-020-05734-5

51. Melnyk M., Casey R.G., Black P., Koupparis A.J. Enhanced recovery after surgery (ERAS) protocols: Time to change practice? Can Urol Assoc J 2011;5(5):342–8. DOI: 10.5489/cuaj.11002

52. Nasser R., Yadla S., Maltenfort M.G. et al. Complications in spine surgery. J Neurosurg Spine 2010;13(2):144–57. DOI: 10.3171/2010.3.SPINE09369

53. Yadla S., Maltenfort M.G., Ratliff J.K., Harrop J.S. Adult scoliosis surgery outcomes: a systematic review. Neurosurg Focus 2010;28(3):E3. DOI: 10.3171/2009.12.FOCUS09254

54. Zaed I., Bossi B., Ganau M. et al. Current state of benefits of Enhanced Recovery After Surgery (ERAS) in spinal surgeries: A systematic review of the literature. Neurochirurgie 2022;68(1):61–8. DOI: 10.1016/j.neuchi.2021.04.007

55. Pennington Z., Cottrill E., Lubelski D. et al. Systematic review and meta-analysis of the clinical utility of Enhanced Recovery After Surgery pathways in adult spine surgery. J Neurosurg Spine 2020 Nov 06:1–23. DOI: 10.3171/2020.6.SPINE20795

56. Koocheki R., Koyle M., Ibrahim G.M. et al. Comparison of interventions and outcomes of enhanced recovery after surgery: a systematic review and meta-analysis of 2456 adolescent idiopathic scoliosis cases. Eur Spine J 2021;30(12):3457–72. DOI: 10.1007/s00586-021-06984-0

57. Gadiya A.D., Koch J.E.J., Patel M.S. et al. Enhanced recovery after surgery (ERAS) in adolescent idiopathic scoliosis (AIS): a metaanalysis and systematic review. Spine Deform 2021;9(4):893–904. DOI: 10.1007/s43390-021-00310-w

58. Tong Y., Fernandez L., Bendo J.A., Spivak J.M. Enhanced recovery after surgery trends in adult spine surgery: a systematic review. Int J Spine Surg 2020;14(4):623–40. DOI: 10.14444/7083

59. Fleege C., Arabmotlagh M., Al majali A., Rauschmann M. Pre- and postoperative fast-track treatment concepts in spinal surgery: patient information and patient cooperation. Orthopade 2014;43(12):1062–4, 1066–9. DOI: 10.1007/s00132-014-3040-5

60. Fletcher N.D., Shourbaji N., Mitchell P.M. et al. Clinical and economic implications of early discharge following posterior spinal fusion for adolescent idiopathic scoliosis. J Child Orthop 2014;8(3):257–63. DOI: 10.1007/s11832-014-0587-y

61. Smith J., Probst S., Calandra C. et al. Enhanced recovery after surgery (ERAS) program for lumbar spine fusion. Perioper Med (Lond) 2019;8:4.DOI: 10.1186/s13741-019-0114-2

62. Ali Z.S., Flanders T.M., Ozturk A.K. et al. Enhanced recovery after elective spinal and peripheral nerve surgery: pilot study from a single institution. J Neurosurg Spine 2019 Jan 25:1–9. DOI: 10.3171/2018.9.SPINE18681

63. Liu B., Liu S., Wang Y. et al. Enhanced recovery after intraspinal tumor surgery: a single-institutional randomized controlled study. World Neurosurg 2020;136:e542–52. DOI: 10.1016/j.wneu. 2020.01.067

64. Rao R.R., Hayes M., Lewis C. et al. Mapping the Road to Recovery: Shorter Stays and Satisfied Patients in Posterior Spinal Fusion. J Pediatr Orthop 2017;37(8):e536–42. DOI: 10.1097/BPO.0000000000000773

65. Shao B., Tariq A.A., Goldstein H.E. et al. Opioid-Sparing Multimodal Analgesia After Selective Dorsal Rhizotomy. Hosp Pediatr 2020;10(1):84–9. DOI: 10.1542/hpeds.2019-0016

66. Debono B., Sabatier P., Boniface G. et al. Implementation of Enhanced Recovery After Surgery (ERAS) protocol for anterior cervical discectomy and fusion: a propensity score-matched analysis. Eur Spine J 2020;30(2):560–7. DOI: 10.1007/s00586-02006445-0

67. Feng C., Zhang Y., Chong F. et al. Establishment and implementation of an Enhanced Recovery After Surgery (ERAS) pathway tailored for minimally invasive transforaminal lumbar interbody fusion surgery. World Neurosurg 2019;129:e317–23. DOI: 10.1016/j.wneu.2019.05.139

68. Li J., Li H., Xv Z.K. et al. Enhanced recovery care versus traditional care following laminoplasty: A retrospective case-cohort study. Medicine (Baltimore) 2018;97(48):e13195. DOI: 10.1097/MD.0000000000013195

69. Wang M.Y., Chang H.K., Grossman J. Reduced acute care costs with the ERAS minimally invasive transforaminal lumbar interbody fusion compared with conventional minimally invasive transforaminal lumbar interbody fusion. Neurosurgery 2018;83(4):827–34. DOI: 10.1093/neuros/nyx400

70. Wang P., Wang Q., Kong C. et al. Enhanced recovery after surgery (ERAS) program for elderly patients with short-level lumbar fusion. J Orthop Surg Res 2020;15(1):299. DOI: 10.1186/s13018-02001814-3

71. Grasu R.M., Cata J.P., Dang A.Q. et al. Implementation of an Enhanced Recovery After Spine Surgery program at a large cancer center: a preliminary analysis. J Neurosurg Spine 2018;29(5):588–98. DOI: 10.3171/2018.4.SPINE171317

72. Angus M., Jackson K., Smurthwaite G. et al. The implementation of enhanced recovery after surgery (ERAS) in complex spinal surgery. J Spine Surg 2019;5(1):116–23. DOI: 10.21037/jss.2019.01.07

73. Bellaire L.L., Bruce R.W. Jr, Ward L.A. et al. Use of an Accelerated Discharge Pathway in Patients With Severe Cerebral Palsy Undergoing Posterior Spinal Fusion for Neuromuscular Scoliosis. Spine Deform 2019;7(5):804–11. DOI: 10.1016/j.jspd.2019. 02.002

74. DeVries Z., Barrowman N., Smit K. et al. Is it feasible to implement a rapid recovery pathway for adolescent idiopathic scoliosis patients undergoing posterior spinal instrumentation and fusion in a single-payer universal health care system? Spine Deform 2020;8(6):1223–9. DOI: 10.1007/s43390-020-00146-w

75. Fletcher N.D., Andras L.M., Lazarus D.E. et al. Use of a Novel Pathway for Early Discharge Was Associated With a 48 % Shorter Length of Stay After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis. J Pediatr Orthop 2017;37(2):92–7. DOI: 10.1097/BPO.0000000000000601

76. Fletcher N.D., Murphy J.S., Austin T.M. et al. Short term outcomes of an Enhanced Recovery After Surgery (ERAS) pathway versus a traditional discharge pathway after posterior spinal fusion for adolescent idiopathic scoliosis. Spine Deform 2021;9(4): 1013–9. DOI: 10.1007/s43390-020-00282-3

77. Gornitzky A.L., Flynn J.M., Muhly W.T., Sankar W.N. A rapid recovery pathway for adolescent idiopathic scoliosis that improves pain control and reduces time to inpatient recovery after posterior spinal fusion. Spine Deform 2016;4(4):288–95. DOI: 10.1016/j.jspd.2016.01.001

78. Muhly W.T., Sankar W.N., Ryan K. et al. Rapid Recovery Pathway After Spinal Fusion for Idiopathic Scoliosis. Pediatrics 2016;137(4):e20151568. DOI: 10.1542/peds.2015-1568

79. Sanders A.E., Andras L.M., Sousa T. et al. Accelerated discharge protocol for posterior spinal fusion patients with adolescent idiopathic scoliosis decreases hospital postoperative charges 22. Spine (Phila Pa 1976) 2017;42(2):92–7. DOI: 10.1097/ BRS.0000000000001666

80. Raudenbush B.L., Gurd D.P., Goodwin R.C. et al. Cost analysis of adolescent idiopathic scoliosis surgery: early discharge decreases hospital costs much less than intraoperative variables under the control of the surgeon. J Spine Surg 2017;3(1):50–7. DOI: 10.21037/jss.2017.03.11

81. Julien-Marsollier F., Michelet D., Assaker R. et al. Enhanced recovery after surgical correction of adolescent idiopathic scoliosis. Paediatr Anaesth 2020;30(10):1068–76. DOI: 10.1111/pan.13988