Abstract: Application of the perioperative surgical home in the surgical treatment of advanced tumors        LI Zi-yu. Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China
Abstract    The perioperative surgical home(PSH) is essentially a patient-centered surgical model, which emphasizes the shared decision making of doctors and patients and the whole process management of patients to reduce medical expenses and improve medical quality. The concept is particularly important in the surgical treatment of advanced tumors, which is mainly reflected in the following aspects. Before surgery, preoperative rehabilitation and the nutritional indicators of patients play an important role to improve perioperative surgery safety and long-term prognosis. During the perioperative period, ERAS is the core of PSH. Besides, the technology and the concept of minimally invasive surgery helps the application of PSH in the surgical treatment of advanced tumors. How to reduce the occurrence of perioperative complications is the basic requirement of PSH for the surgical treatment of advanced tumors. The sequence and timing of perioperative therapy is an important manifestation of the whole process management of PSH. The shared decision making is an important feature of PSH, which is not only the highlights of humanistic care but also the development of individualized treatment and precision treatment in the era of evidence-based medicine. The PSH is the direction of future medical development, instead of a new concept.

Key words: perioperative surgical home；advanced tumor；shared decision-making, whole process management, enhanced recovery after surgery

摘要： 围手术期外科之家理念本质上是一种以病人为中心的外科模式，它强调医患共同决策及病人的全流程管理，以达到降低医疗开支，提升医疗质量的目的。这一理念在进展期肿瘤的外科治疗中尤为重要，主要体现在以下几方面。在术前，关注病人营养指标，进行术前预康复，提高病人的围手术期安全性和长期预后；在围手术期，加速康复外科（ERAS）是围手术期外科之家理念的核心，而微创外科技术和理念的发展也助力其在进展期肿瘤外科治疗的应用；降低围手术期并发症发生率，是围手术期外科之家理念对进展期肿瘤外科治疗的基本要求；关注进展期肿瘤围手术期综合治疗时序则是围手术期外科之家理念中全流程管理的重要体现；医患共同决策模式是围手术期外科之家的重要特征，既突显人文关怀，是以病人为中心的重要体现，亦是目前循证医学时代中如何更好地开展个体化治疗及精准治疗的发展方向。围手术期外科之家理念不仅仅是一个新的概念，其应用是未来医学发展的趋势和方向。

关键词: 围手术期外科之家, 进展期肿瘤, 共同决策, 全流程管理, 加速康复外科