术后早期经口进食在结直肠癌快速康复外科的应用

Clinical application of early postoperative oral feeding in fast track surgery of colorectal cancer

目的探讨术后12小时内经口进食在结直肠癌快速康复外科中的临床应用。方法将入选的70例拟接受限期手术的结直肠癌患者随机分为早期进食组(术后12小时内开始进食)和传统进食组(术后肛门排气后开始进食),每组35例,两组都接受快速康复外科治疗。结果 62例患者完成试验,早期进食组32例,传统进食组30例;早期进食组患者术后住院时间分别为(6±1)d和(11.7±3.82)d,首次排气时间(2±1)d和(4±2)d,首次排便时间(3.84±1.63)d和(6.44±2.53)d,首次耐受半流时间(4±2)d和(8.2±2.16)d,以上参数早期进食组均比传统进食组短(P<0.001)。结论术后12小时内经口进食在接受快速康复外科的限期手术结直肠癌患者中安全有效,在没有增加并发症发生率的前提下,明显加快了术后肠道功能的恢复,显著缩短了术后住院时间。

Objective To investigate the clinical application of early postoperative oral feeding in fast track surgery of colorectal cancer.Methods Seventy patients with colorectal carcinoma requiring elective colorectal resection were randomized to two groups:early oral feeding group (35 cases) and conventional oral feeding group (35 cases).The patients in early oral feeding group started oral feeding within 12 hours after operation,while patients in conventional oral feeding group started oral feeding after the first postoperative passage of flatus.Both groups received a fast-track surgery program.Postoperative recovery status and hospital stay were compared between the two groups.Results Sixty-two patients eventually completed the study,32 cases in early oral feeding group and 30 cases in conventional oral feeding group.The median and average days of the first passage of flatus[(2±1)d vs.(4±2)d,P<0.0001],the first passage of stool[(3.84±1.625)d vs.(6.44±2.526)d,P=0.0007],resumption of normal diet [(4±2)d vs.(8.2±2.16)d,P<0.0001] and the length of postoperative stay [(6±1)d vs.(11.7±3.82)d,P<0.0001)] were much shorter in the early oral feeding group than those in the conventional oral feeding group.Conclusions The application of early postoperative oral feeding in patients undergoing elective colorectal resection,who received a fast track surgery programme,was safe and effective.It led to a faster recovery of bowel function and shorter postoperative hospital stay without increasing postoperative complications.