快速康复外科在腹腔镜辅助全胃切除术围手术期的应用

Applications of Fast Track Surgery in Laparoscopy-Assisted Radical Total Gastrectomy during the Perioperative Period

目的:探讨快速康复外科(fast track surgery, FTS)在腹腔镜辅助根治性全胃切除术围手术期治疗中的可行性和有效性。方法选取2010年1月~2012年12月76例胃癌需行腹腔镜辅助根治性全胃切除术的患者,随机分为快速康复(FTS)组和传统治疗组(对照组),每组38例。快速康复组围手术期应用快速康复处理方案,传统治疗组应用传统的围手术期处理方案。观察两组术后首次排气时间、术后住院天数、住院总费用及术后并发症等指标。结果 FTS组与对照组比较,首次排气时间提前(P=0.001)、术后的住院时间缩短(P=0.000)、住院总费用减少(P=0.000),术后并发症发生率没有增加(P=0.317)。结论在快速康复外科理念指导下手术可减轻手术的损伤,提高患者舒适度,促进胃癌患者术后的康复,缩短术后住院时间,节省住院总费用。

Objective:To explore the feasibility and ef ectiveness of fast track surgery(FTS)in the treatment of laparoscopy-assisted radical total gastrectomy during the perioperative period.Methods:Select 120 cases that were treated with laparoscopy-assisted radical total gastrectomy from January 2010 to December 2012,and randomly divide them into two groups:FTS group and traditional treatment group(control group),60 for each.FTS group is given fast track treatment scheme during the perioperative period,and traditional treatment group is given traditional perioperative treatment scheme.Observe the data of both groups:the first exsuf lation time after operation,hospitalization days after operation,total hospitalization expenses and postoperative complications.Results:As compared with control group,FTS group produces the fol owing results:the first exsuf lation time is earlier(P=0.001);duration of hospitalization after operation is shortened(P=0.000);total hospitalization expenses reduce(P=0.000);incidence of postoperative complications does not increase(P=0.317).Conclusions:Under the guidance of the concept of fast track surgery,operations have the fol owing advantages:reducing operative injury,improving comfort index of patients with gastric cancer,promoting postoperative rehabilitation of patients with gastric cancer,shortening duration of hospitalization after operation and saving total hospitalization expenses.