The operation "sleeps three nights", and the child suffers less! Nanjing Children's Hospital promotes the concept of accelerated rehabilitation surgery

Modern Express News (correspondent Yu Lulu Zhang Aixuan reporter Liu Jun) let children suffer less and let parents worry less! Recently, the Modern Express reporter learned from Nanjing Children's Hospital that after years of efforts, the concept of accelerated rehabilitation surgery has gradually matured. Tang Weibing, director of the Department of Neonatal Surgery of Nanjing Children's Hospital, told the Modern Express that the promotion of this new concept has greatly reduced the physical, psychological trauma and stress response caused by medical behavior to children, not only making children suffer less, allowing parents to spend less money, but also shortening the length of hospitalization, effectively saving medical resources, and obtaining better patient satisfaction. In the future, the hospital will continue to promote this technology in surgical operations to serve more children in need.

Recently, a child with a celiac tumor underwent tumor resection surgery at the Neonatal Surgery Department of Nanjing Children's Hospital. With the support of accelerated rehabilitation surgery, the child got out of bed to walk and eat on the first day after surgery, stopped hanging water on the 4th day, and was discharged from the hospital at 1 week. Two-year-old Yang Yang (pseudonym) has had repeated abdominal pain for more than a year. Recently, due to the aggravation of pain, even unable to eat, to the local hospital for treatment, the results were found to have abdominal tumors. Abdominal pain in children is caused by tumors pulling or compressing the intestines, and the tumor needs to be removed surgically as soon as possible. After the child was transferred to Nanjing Children's Hospital, from the ultrasound and CT examination, it can be seen that the tumor in the abdominal cavity is very large, and in the position of the small intestine, it is larger than the fist of an adult man. "Previously, such a large tumor required a large opening across the abdomen. Today, minimally invasive surgery with the help of laparoscopic techniques can remove the tumor with a small opening. Tang Weibing said.

Yangyang's surgery was performed on the morning of November 19, and when parents asked about preoperative preparations, they were surprised and relieved to receive answers. "I didn't eat or wash my intestines for the first 1 day, I drank milk 4 hours before surgery, and I drank sugar water for 2 hours. The night of the 18th was the same as usual, and the child fell asleep peacefully after eating enough, without crying at all," Yangyang's mother said.

During the operation, the doctor made a small opening of only 3 centimeters under the navel, which ended in more than 1 hour. After the anesthesia was awakened, in order to make there be no pain after the Yangyang surgery, the medical team adopted a multi-mode analgesic method such as "injecting local anesthetics + listening to music + oral analgesics when suturing the incision". This also creates conditions for children to get out of bed early. On the morning of the first day after the operation, Yang Yang, under the care and help of the nurses, got out of bed and moved, and drank milk in the afternoon. "At this time, parents may be worried that the intestines will eat just after being picked up, and will not break the intestines, right? In fact, there are clear research data that show that eating early after surgery can provide nutrition for the body and promote the recovery of intestinal function. Director Tang introduced.

On the 4th day after the operation, the Yangyang diet reached the normal amount, the physical and mental state was well restored, and his mother even took him downstairs in the ward to bask in the sun. "Less than a week after the removal of the tumor and lesions, the intestinal tract has recovered to eat and move like a normal child," the child's mother lamented.

Tang Weibing told reporters that the child's recovery so quickly is closely related to the perioperative management of accelerated rehabilitation surgery. Accelerated rehabilitation surgery refers to the optimization of the clinical path of perioperative treatment based on evidence-based medical evidence, with the purpose of reducing the physiological and psychological trauma stress response of surgical patients, through multidisciplinary collaboration such as surgery, anesthesia, nursing, nutrition, etc., so as to reduce perioperative stress and postoperative complications, shorten the length of hospital stay, and promote patient recovery.

Accelerated rehabilitation surgery is a new perioperative management model, which is generally divided into three stages: preoperative, intraoperative and postoperative. "In the past, before the operation, the children were very nervous and the parents were also anxious. Some children cannot eat before surgery, but also wash their intestines, and before the operation has begun, the child will not be able to eat. Tang Weibing said that now with the new technology, patients can sleep peacefully at night and wait for tomorrow's surgery.

Under the accelerated rehabilitation surgery technology, it can be said that it is comfortable to "sleep three nights", and the operation is over. The day before the operation can eat and drink, the child can sleep with peace of mind; the intraoperative infusion is warm, the room and bed are warm, the operation is minimally invasive, and it can warm up and sleep; effective analgesia after the operation, quickly restore diet, and can also make up for a sleep.

Tang Weibing told reporters that Nanjing Children's Hospital began to accept the concept of accelerated rehabilitation surgery since 2014 and gradually promoted it. After seven or eight years of practice and efforts, it was found that accelerated rehabilitation surgery is indeed very beneficial to children, which can make our children recover as soon as possible, and also speed up the turnover of hospital beds. "The patient's hospital stay is short, the medical cost is less, and the national medical insurance fund is also less, which is actually a win-win situation between our patient hospital and the medical insurance fund." Tang Weibing said that this is a good method and a good measure, and the hospital will continue to vigorously promote it.