Evaluation of the application of enhanced recovery after surgery principles in perioperative management for patients undergoing non-interventional retrieval of inferior vena cava filters
Background and Aims:The enhanced recovery after surgery(ERAS)concept involves integrating and optimizing perioperative interventions based on evidence-based medical principles and multidisciplinary collaboration.It has been implemented across various surgical fields and has gained widespread recognition.Permanent retention of an inferior vena cava filter(IVCF)can lead to various complications.Guidelines recommend retrieving the filter when the risk of deep vein thrombosis decreases.However,retrieval can be challenging or unsuccessful due to complications such as filter tilt,adherence,perforation,or migration.In such cases,non-interventional surgical methods like laparoscopic or open IVCF retrieval may be employed,though these methods are associated with significant surgical trauma and postoperative complications.There are no reports on the application of ERAS in non-interventional IVCF retrieval.Therefore,this study explores the effectiveness of ERAS-guided perioperative management in patients undergoing non-interventional IVCF retrieval.Methods:The clinical data from 34 patients who underwent non-interventional IVCF retrieval were retrospectively analyzed.Among them,20 patients(from January 2022 to June 2023)received perioperative management based on ERAS principles(observation group),while 14 patients(from July 2020 to December 2021)received traditional perioperative management(control group).Baseline characteristics and intraoperative and postoperative indicators were compared between the two groups.Results:The observation group had a higher average age than the control group(51.2 years vs.39.5 years,P＜0.05).Other factors,including sex,body mass index,preoperative hemoglobin level,medical history,IVCF placement reasons,IVCF location,IVCF type,number of interventional retrieval attempts,IVCF indwelling time,and retrieval methods,showed no significant differences between the groups(all P＞0.05).The observation group had lower intraoperative blood loss,shorter operative time,fewer ICU admissions,shorter nasogastric tube retention time,shorter length of postoperative hospital stays,and lower pain visual analogue scale scores 6 h after operation(all P＜0.05).The overall incidence of complications was lower in the observation group,though the difference was not statistically significant(25.0％vs.50.0％,P＞0.05).Additionally,the observation group had a higher score on the comfort scale(88.5 vs.82.3,P＜0.05)and lower total hospital costs(44 000 yuan vs.54 000 yuan,P＜0.05).Conclusion:The implementation of ERAS management measures in non-interventional IVCF retrieved patients during the perioperative period has a good effect,and the intraoperative measures are safe and effective and have positive effects in promoting patient recovery,alleviating pain,and improving patient treatment experience.
Vena Cava FiltersDevice RemovalEnhanced Recovery After SurgeryPerioperative Period
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