To investigate the efficacy of enhanced recorery after surgery (ERAS) nursing in patients undergoing robot-assisted hiatal hernia repair (RHHR).

A retrospective analysis was conducted on 60 patients who were hospitalized for RHHR in the Minimally Invasive Surgery Department, Hernia and Abdominal Wall Surgery Department of Xinjiang Uygur Autonomous Region People’s Hospital from October 2022 to December 2024. The patients were divided into an ERAS group and a control group, with 30 patients in each group, based on their nursing care. The control group received routine nursing care, while the ERAS group received ERAS-based nursing care in addition to routine care. Comparison of postoperative first oral intake time, first defecation time, postoperative hospital stay, total hospitalization duration, economic benefits, postoperative pain scores, venous thromboembolism (VTE) risk, and incidence of postoperative cough and sputum production between the two groups by Wilcoxon signed rank sum test, t-test and χ² test.

ERAS group demonstrated significantly improved postoperative recovery, with earlier first oral intake [8.0(6.0, 15.0)h vs 14.0(10.0, 21.0)h; Z=-5.440, P<0.001], first flatus [10.0(9.0, 12.0)h vs 20.0(16.0, 23.0)h; Z=-5.598, P<0.001], and first bowel movement [12.0(10.0, 13.0)h vs 21.0(17.7, 25.0)h; Z=,-5.687 P<0.001] when compared to the control group, furthermore, the ERAS group experienced significantly shorter postoperative hospital stay [3.5(2.0, 4.2)d vs 6.0(4.0, 10.5)d; Z=-3.858, P<0.001] and total hospitalization duration [12.5(9.0, 14.3)d vs 19.0(14.0, 23.0)d; Z=-3.880, P<0.001], when compared to the control group. Economically, total costs were significantly lower in the ERAS group [(59 111±11 670)yuan vs (73 533±14 632)yuan] compared to the control group (t=-4.220, P<0.001). Pain scores were significantly lower in the ERAS group on postoperative days [2.0(2.0, 4.0)vs 4.0(4.0, 4.0); Z=-3.768, P<0.001] and 2 [1.0(0, 1.0)vs 2.0(1.7, 2.0); Z=-6.134, P<0.001], and also on day 3 [0(0, 1.0) vs 1.0(0, 1.0); Z=-2.531, P=0.011], when compared to the control group. The ERAS group also showed a lower VTE score on discharge day [0(0, 1) vs 1(0, 1); Z=-2.393, P=0.017] and a significantly lower incidence of postoperative cough and sputum (1/30 vs 7/30; χ²=5.192, P=0.023) when compared to the control group.

ERAS perioperative nursing can promote gastrointestinal function recovery, shorten hospital stay, reduce postoperative pain and hospitalization cost in patients undergoing robotic hiatal hernia repair.