无肠道准备对食管切除术后并发症及康复速度的影响

A randomized controlled study on the effect of no bowel preparation on postoperative complications and rehabilitation after esophagectomy

目的:研究食管切除术前无肠道准备的安全性及其对患者康复速度的影响。方法:2021年6月—10月,便利选取3所三级甲等医院的236例食管切除患者为研究对象,随机分为实验组和对照组,其中实验组117例,对照组119例。实验组术前不进行肠道准备,只禁食水,对照组术前1天口服复方聚乙二醇电解质散进行肠道准备。比较术后14天内两组患者的吻合口瘘发生率和综合并发症指数,围手术期感染相关血液指标和血清电解质平衡情况,以及术后恢复指标。结果:实验组发生吻合口瘘6例(5.1%),对照组发生9例(7.6%),差异无统计学意义(P>0.05)。实验组综合并发症指数为5.47±9.73,对照组为7.67±12.17,差异无统计学意义(P>0.05)。实验组进食时间、下床活动时间及术后住院时长均优于对照组(P<0.05)。结论:食管癌患者食管切除术前不进行肠道准备是安全的,能够加速患者术后康复。

Objective:To study the safety of no bowel preparation before esophagectomy and its effect on the recovery of patients.Methods:A multicenter randomized controlled study was conducted from June to October 2021.A total of 236 patients from three tertiary Grade A hospitals were randomly divided into experimental group(117 cases)and control group(119 case).Those in the experimental group did not get bowel preparation before operation,and only with preoperative fasting and water deprivation.Those in the control group were orally prepared with compound polyethylene glycol electrolyte powder one day before operation.The incidence of anastomotic leakage and comprehensive complication index within 14 days after operation,perioperative infection,electrolyte balance,as well as postoperative recover indicators were compared.Results:Anastomotic leakage occurred in 6 cases(5.1%)in the experimental group and 9 cases(7.6%)in the control group,and the difference was not statistically significant(P>0.05).The comprehensive complication index was 5.47±9.73 in the experimental group and 7.67±12.17 in the control group,and the difference was not statistically significant(P>0.05).The time of eating,the time of getting out of bed and the length of postoperative hospitalization of those in the experimental group were better than those of the control group(P<0.05).Conclusion:No bowel preparation before esophagectomy is safe for patients with esophageal cancer,and it can accelerate the postoperative recovery of patients.