腹腔镜结直肠癌根治术中快速康复外科的应用

Laparoscopic resection of colorectal cancer guided by fast-track surgery

目的观察腹腔镜结直肠癌根治术中,围手术期快速康复外科(FTS)应用于临床的安全性和有效性。方法结直肠癌限期手术患者31例,按照收治时间的差异而采用的不同治疗方法分为两组:FTS组14例按快速康复理念行围手术期处理,对照组17例按传统方法行围手术期处理。临床观察指标两组进行比较并对结果进行分析。结果 FTS组术后下床时间、肠功能恢复排气时间、自行排尿时间、进食时间与对照组比较均显著提前,术后住院时间明显缩短,差异有统计学意义(P<0.05)。术后不良反应发生率FTS组2例,传统组3例。其中对照组于术后第5天发现左下肢深静脉血栓形成1例,经溶栓处理3天后好转;发生吻合口漏2例对症治愈。FTS组发生不全性肠梗阻1例,吻合口漏1例均对症处理治愈。结论腹腔镜手术加FTS技术的应用能加速结直肠癌手术患者的术后康复,值得临床推广应用。

Objective To explore the safety and efficacy of fast track surgery in colorectal cancer radical operation with laparoscopes in the perioperative period. Methods 31 cases of patients with colorectal cancer surgical operation treatment. One group was treated by FTS and the other was treated by traditional method during preoperative period. Compared two groups of patients with the time of out bed, voluntary urination, passage of gas by anus, liquid, stop intravenous infusion, postoperative hospital stay, hospital charges, and adverse reaction in perioperative period,then analyzed the results. Results Compared with the control group, the time of out bed, voluntary urination,passage of gas by anus, semi-liquid, stop intravenous infusion, postoperative hospital stay of FTS group was shorter, hospital costs were reduced, P 〈 0. 05. Conclusions Fast track surgery in colorectal cancer radical operation with laparoscopes in the perioperative period can accelerate recovery of intestinal function, not increase postoperative complications and help postoperative rehabilitation, is worthy of clinical application.