Objective To analyze the perioperative efficacy of enhanced recovery after surgery (ERAS) in the treatment of lumbar disc herniation using unilateral biportal endoscopy technique. Methods A total of 55 patients who received unilateral biportal endoscopy technique for the treatment of lumbar disc herniation in Tianjin Hospital between January and December 2020 were selected and randomly divided into the traditional group and the ERAS group according to random number table method. The routine inpatient care management was adopted in the traditional group, while the holistic integrated care plan was formulated in the ERAS group according to the multidisciplinary collaboration of the accelerated rehabilitation plan. The first postoperative exhaust time, the first time out of bed, length of hospital stay, hospital costs, Visual Analogue Scale (VAS) scores before operation, one day and three days after operation, Oswestry Disability Index (ODI) scores before operation and one month after operation, and the excellent and good rate of modified MacNab efficacy one month after operation were compared between the two groups. Results There were 28 cases in the traditional group and 27 cases in the ERAS group. The first postoperative exhaust time [(2.31±1.02) vs. (3.19±0.87) h], the first postoperative ambulation time [(1.06±0.40) vs. (2.00±0.53) d], length of hospital stay [(3.8±0.8) vs. (4.6±0.8) d], and hospital cost [(32.18±9.10) thousand yuan vs. (39.81±11.10) thousand yuan] in the ERAS group were all less than those in the traditional group, and the differences were statistically significant (P<0.05). The VAS scores of the ERAS group one day after operation (3.2±0.8 vs. 4.1±0.8) and three days after operation (1.4±0.5 vs. 1.7±0.5) were lower than those of the traditional group (P<0.05). The ODI scores of the ERAS group one month after operation was lower than that of the traditional group (13.3±4.0 vs. 16.6±4.8, P<0.05). In the modified MacNab efficacy evaluation one month after surgery, there was no significant difference in the excellent and good rate between the ERAS group and the traditional group (96.3% vs. 96.4%, P>0.05). Conclusions ERAS regimen can significantly accelerate the patients’ recovery, including shortening the first exhaust time, facilitating early ambulation, and reducing the hospital stay and hospitalization expenses. Meanwhile, ERAS regimen can effectively reduce the postoperative pain of the patients, and promote early functional recovery.
Objective To compare endoscopic sinius surgery plus middle meatus fenestration with endoscopic sinius surgery plus middle and inferior meatus fenestration for fungus ball maxillary sinusitis. Methods Applying a prospective randomized controlled trial, 80 patients with fungal ball maxillary sinusitis from January, 2010 to March, 2011 were collected and then divided into two groups, including experiment (40 cases) and control groups (40 cases). The trial group received endoscopic sinius surgery plus middle and inferior meatus fenestration, which the control group received endoscopic sinius surgery plus middle meatus fenestration. Then a follow-up was conducted from the end of surgery to February 28th, 2013. All patients took subjective and objective assessment before and after the surgery, including VAS, SNOT-20, Lund-Mackay CT system scores and Lund-Kennedy endoscopic mucosal score. Results with the trial group was superior to the control group in VAS score, SNOT rating and Lund-Kennedy mucosa score 6 months, 1 year, and 2 years after surgery (Plt;0.01). Lund-Mackay CT score of the control group was significantly higher than the trial group after 1 year of surgery (Plt;0.01). According to the Haikou standard to assess the efficacy of surgery, we found that the total effectiveness rate of the trial group (100.0%; recovery: 36 cases; improved: 4 cases) was higher than that of the control group (87.5%; recovery: 28 cases; improved: 4 cases), with a significant difference (P=0.021). Conclusion Endoscopic sinius surgery plus middle and inferior meatus fenestration with a lower reoccurrence rate is superior to endoscopic sinius surgery plus middle meatus fenestration for fungus ball maxillary sinusitis in clinical efficacy.