加速康复外科及腹腔镜在胃癌中的应用研究

目的:评价加速康复外科(fast track surgery,FTS)新理念及腹腔镜技术常规应用于胃癌根治术的可行性.方法:回顾分析2005年3月至2010年3月由同一医师完成的胃癌根治术的临床资料,按围手术期理念和手术技术分为3组,A组(66例)采用传统围手术期处理方法行开腹手术,B组(105例)应用FTS理念行开腹...

Fast-track surgery and laparoscopy in gastrectomy for gastric cancer

Objective: To evaluate the feasibility of fast-track surgery(FTS) and laparoscopy as a routine perioperative management in gastrectomy for gastric cancer. Methods:The clinical data of patients who underwent gastrectomy performed by the same surgeon from Mar.2005 to Mar.2010 were retrospectively analyzed.The patients were divided into three groups according to the perioperative measures and surgical technique,group A(66 cases) was open gastrectomy with traditional perioperative treatment,group B(105 cases) was open gastrectomy with FTS,and group C(100 cases) was laparoscopic gastrectomy with FTS.Clinical data and lab index were compared in the three groups. Results:The operation time was significantly different among the three groups(P<0.05),and the group C was the longest with least blood loss(P<0.05).No significant difference existed in the number of resected lymph node and postoperative complications among the three groups(P>0.05).In group B and C,the recovery of bowel function was faster(P<0.05),the postoperative hospital stay was shorter(P<0.01),and the surgical stress response was minor(P<0.05),compared with group A.Recovery of bowel function in group C was a little faster,postoperative hospital stay was a little shorter,and surgical stress response was a little minor than group B,but with no significant difference(P>0.05) except the C-reactive protein(P<0.05). Conclusions:FTS is essential for improvement of postoperative recovery of patients with stomach cancer,and should be followed in the open and laparoscopic gastrectomy.FTS combined with laparoscopy is superior to traditional stomach cancer treatment.