加速康复外科用于直肠癌前切除病人价值探讨

Fast track rehabilitation in rectal cancer patients undergoing anterior resection

目的比较直肠癌前切除术采用加速康复外科治疗与传统围手术期处理方法的安全性及有效性。方法2006年11月至2007年6月在南京军区南京总医院对20例直肠癌行根治性前切除手术病人采用加速康复外科治疗(加速康复组),和同期22例按传统方法进行围手术期处理的直肠癌病人(传统方法组)作对照。比较两组病人术后住院时间、恢复肠排气时间、停止静脉输液的时间、营养状态的变化,和治疗费用以及两组术后并发症的发生情况。结果加速康复外科组与传统方法组相比,前组术后住院时间缩短,治疗费用降低,术后首次肠道排气时间提前,停止静脉输液时间提前,手术后体重下降减轻。两组术后并发症的发生率差异无显著性意义。结论直肠癌经腹前切除术行加速康复外科治疗是安全、有效的方法,既有利病人术后器官功能的康复,又可以减少住院时间与治疗费用。

Objective This study was designed to compare fast track surgery with conventional perioperative management in rectal cancer patients undergoing anterior resection. Methods 42 rectal cancer patients undergoing anterior resection were recruited for this comparative study. 20 patients received perioperative fast track rehabilitation;meanwhile other 22 received conventional perioperative care. Outcomes were assessed by length of postoperative hospital stay, medical cost, nutritional status, gut function, and postoperative complication. Results Fast track rehabilitation group was associated with a significantly shorter postoperative hospital stay, less medical cost, earlier first passage of flatus, less loss of body weight in the postoperative period compared with conventional care group, and there were no differences in morbidity or mortality between two groups. Conclusion Fast track rehabilitation was feasible and effective in rectal cancer patients undergoing anterior resection.