结直肠癌同时肝转移运用快速康复理念同期切除的效果

Application of fast track surgery to simultaneous resection of colorectal cancer with synchronous liver metastasis

目的结直肠癌同时肝转移患者行同期切除围术期采用快速康复理念的临床效果。方法将2010-01至2016-12北京大学肿瘤医院共76例同期行原发灶切除与肝切除患者随机分为快速康复外科(Enhanced recovery after surgery,ERAS)组和传统康复组,每组38例,分别实施快速康复理念及常规康复理念。观察两组间首次排气时间、恢复正常饮食时间、住院时间、并发症发生率及再次入院率之间的差异。结果术后首次排气时间、恢复正常饮食时间及住院时间,ERAS组分别为(3.12±1.03)d、(5.63±1.37)d、(9.20±1.36)d,传统康复组分别为(4.67±1.57)d、(7.87±1.62)d、(11.36±1.74)d,ERAS组各项天数短于传统康复组,差异有统计学意义(均P<0.05);而并发症总发病率、再次入院率,ERAS组分别为4(10.5%)、3(7.9%),传统康复组分别为3(7.9%)、2(5.3%),两组比较无明显增加(P>0.05)。结论快速康复理念应用于结直肠癌同时性肝转移同期切除围手术期康复具有良好的临床效果,值得推广应用。

Objective To investigate the clinical effect of fast track surgery in simultaneous resection of colorectal cancer with synchronous liver metastasis. Methods A total of 76 patients with primary resection and liver resection treated between January 2010 and December 2016 were randomly divided into two groups： ERAS（ enhanced recovery after surgery,ERAS） group and normal group.There were 38 cases in either group. ERAS nursing and routine nursing were performed respectively in the two groups. The difference between the two groups in the first exhaust time,the time taken to return to normal diet,length of hospital stay,complication rate and the readmission rate were observed. Results The first exhaust time,time taken to resume normal diet and length of hospitalization in the fast track surgery group were（ 3. 12 ± 1. 03） days、（ 5. 63 ± 1. 37） days and（ 9. 20 ± 1. 36） days,compared with（ 4. 67 ± 1. 57）days、（ 7. 87 ± 1. 62） days and（ 11. 36 ± 1. 74） days in the normal group. The difference was statistically significant（ P〈0. 05）. The rates of complications and readmission in the ERAS group were 4（ 10. 5%） and 3（ 7. 9%） respectively,compared with 3（ 7. 9%） and 2（ 5. 3%） in normal group. There was no significant increase between the two groups. Conclusions The application of ERAS to simultaneous resection of colorectal cancer with synchronous liver metastasis has a good clinical effect.