Commentary: Computational Analysis for ERAS and Other Surgical Processes: Commentary From Clinical Perspective.

A Commentary on:

Nowadays, many diseases need to be treated or diagnosed by surgery (1). Surgical treatment can produce better improvement on body function of patients compared with non-surgical treatment (2). However, surgery often result in a high complication rate, which will affect postoperative recovery and lengthen hospital stay (3, 4). In addition, surgery usually results in psychological problems of patients such as anxiety and depression (5, 6). Therefore, an optimized nursing method with physiological and psychological care is required for patients (7, 8).

The theory of enhanced recovery after surgery (ERAS) was first proposed by Kehlet (9), which refers to a standardized method of perioperative nursing and a multi-mode approach that combines preoperative and postoperative nursing methods to reduce the stress associated with surgery, thus allowing for accelerated recovery after surgical treatment (10). ERAS nursing has been proved to be a beneficial way of improving patients’ function (11). A large amount of evidences have shown that ERAS pathway can bring various positive effects, including reduce complication rate after surgery and the risk of death, decreasing readmission rate, length of stay and hospitalization expenses (12, 13). Kobayashi’s study indicated that the implement of ERAS pathways can reduce the probability of postoperative complication for each surgical complexity of liver resection of patients (14). Fay and Gwacham’s research have proved that the use of ERAS protocol was associated with significant decrease in hospital stay and discharge expenses (15, 16). It is reported that following ERAS nursing has been proved a better improvement in patients’ psychological status and their quality of life (17, 18). The research results of Li and her team about ERAS nursing are presented in Table 1, which are consistent with the previous studies.

TABLE 1

Statistical results of different research contents.

Research contents	ERAS nursing	Routine nursing	Statistical value
Postoperative complications rate (%)	7.22	19.44	p < 0.01**
Anal exhaust time (h)	33.30 ± 3.26	64.50 ± 3.28	p < 0.05*
free movement time out of bed (h)	19.80 ± 4.26	33.72 ± 2.32	p < 0.05*
Average length of hospital stay (d)	9.07 ± 1.26	18.01 ± 2.26	p < 0.05*
Degree of satisfaction (%)	98.30	85.00	p < 0.05*
Quality of life (including 7 items)	–	–	p < 0.01**

p < 0.05; **p < 0.01.

Statistically, p < 0.05 means that the result is statistically meaningful, and p < 0.01 means that there is significant difference. This study proved ERAS pathways to be an effective way to improve patients’ recovery and their quality of life by using a computational statistical analysis, which inspired us to realize more about the application of computer in surgical engineering.

With the rapid development of computer, especially the popularity of microcomputers, computer technology has penetrated into almost all fields of medicine and its management (19). In ERAS nursing pathways and surgical process, computers can be used to obtain, store, transmit, process and utilize all kinds of information about medicine and medical management. It can be also used for patients’ registration and appointment, medical record management, ward management, clinical monitoring, dietary management, health examination registration, patient checkout and discharge, medical assistant diagnosis and decision-making (20, 21).

General surgical process includes the registration of patients’ medical records, hospital information management, computer-aided diagnosis, etc., which can be quickly and conveniently realized by computer technology and have been widely used in medical management. Electronic medical records are the computerization of traditional medical records, which are rapidly replacing the original handwritten medical record to use memory cards, computers and other electronic facilities to store, query and refine the diagnosis and treatment process of patients in surgery (22). Its convenience in inputting, sharing and storing information make it into the priority for hospitals (23). Hospital information systems refer to a comprehensive and integrated computer network system that supports the collection and management of massive hospital information (24). Computer-aided diagnosis and decision-making system (CAD&CMD) can help doctors shorten the diagnosis time, avoid omissions, reduce labor intensity and refer to other experts’ opinions, so as to make a diagnosis as soon as possible and propose a treatment plan (25).

Computer also plays an important role in nursing work. The application of computer in nursing work is mainly divided into three aspects: (1) Nursing, including nursing records, nursing examination, patient monitoring, drug management, etc. (2) Nurse education, including nursing education, nursing teaching plan and management of academic record. (3) Nurse management, including the scheduling of nurse service plan, human resource management, and the inspection or appraisal of nurses’ work quality (26, 27, 28). These can be massively used in ERAS nursing process.

For medical stuff, a lot of information needs to be processed in clinical research, experimental research and epidemiological investigation. The application of computer can calculate and process these data accurately and quickly. For this purpose, various computer languages such as SAS, SPSS, SYSTAT and RDAS have been developed by many software packages, of which one of the most commonly used software is SPSS (29, 30, 31).

In recent years, computer technology has been applied in more and more fields in medicine, which has become a hot research object and widely concerned. With the development of computer technology in the medical field, computers play an irreplaceable role in medical research, clinical diagnosis and treatment, pharmacological studies and molecular interactions (32, 33). The application of computer in perioperative period and surgical nursing is constantly maturing, which greatly improves the working efficiency of medical staff. Although this article only shows a small part of the application of computer technology in medicine, Li and her team’s research inspired the thinking about computational analysis in medical field and aroused our attention to more application of computer technology in medicine, which provide a good reference for further research of computational analysis on surgery.