食管癌快速康复外科应用效果分析

Analysis on fast track surgery after esophagectomy of esophageal cancer

目的:探讨快速康复外科(FTS)在食管癌手术中应用的可行性。方法:选取160例同期住院食管癌适合手术治疗的患者,随机分为2组,分别采用FTS方案及传统方法治疗(对照组)。比较2组术后首次排气、排便时间,并发症发生率,住院时间,再住院率及住院费用。结果:FTS方案组:术后首次排气时间(42±2)h,首次排便时间(85±3)h,住院时间(9±1)d,总并发症发生率7.9%(6/76),术后1a再入院率5.3%(4/76),住院总费用(11298.15±2460.95)元。对照组:术后首次排气时间(48±3)h,首次排便时间(95±1)h,住院时间(12±2)d,总并发症发生率18.8%(15/80),术后1a再入院率1.3%(1/80),住院总费用(12537.51±2965.89)元。2组首次排气和排便时间、住院时间、住院总费用、总并发症发生率比较差异均有统计学意义(P<0.05)。结论:FTS方案的应用可有效促进食管癌患者术后的康复,减少术后并发症发生,缩短住院时间,降低住院费用。

Aim： To investigate the feasibility of fast track surgery（FTS） application in respectable esophageal cancer surgery. Methods：A total of 160 consecutive patients with respectable esophageal cancer were randomized into two groups. One group was treated with the new concept of FTS, and the other group was treated with the traditional methods of operation （the control）. The time of the first flatus and the defecation, the morbidity of the postoperative complication, the median hospital stay, the rate of readmission and the total cost during hospitalization were compared respectively. Results： In FTS group, the first flatus time was（42 ±2） h,the first defecation time was （85 ±3） h, the median hospital stay was （9 ± 1） d, the rate of overall complications was 7. 9% （6/76） , and the total cost during hospitalization was （ 11 298. 15 ± 2 460.95 ） Yuan, the rate of readmission was 5.3 % （4/76）. In the control group, the values of the indexes mentioned abore were（48±3） h,（95±1） h,（12±2） d,18.8%（15/80）,（12537.51 ±2 965.89） Yuanand1.3% （1/80）.Therewere significant differences in five out of the 6 indexes except the rate of readmission between the two groups. Conclusion ： The new concept of FTS apparently accelerates recovery after esophageal resection, reduces the rate of overall complications and total cost during hospitalization.