腹腔镜结直肠癌手术患者围手术期应用快速康复外科的系统评价

目的系统评价腹腔镜结直肠癌手术患者应用快速康复外科（FTs）的安全性和有效性。方法计算机检索2000年1月至2012年3月CNKI、万方、Pubmed、EMBACE、CochraneLibrary数据库关于腹腔镜结直肠癌根治术围手术期应用FTS的随机对照试验（RCT）或临床对照试验（CCT）。采用RevMan5．1软件进行Meta分析。结果6项RCT和7项CCT研究纳入研究．共1795例患者，其中FTS组955例，对照组840例。与对照组相比．FTS组患者术后排气更快（WMD=-1．37，95％CI：-1．55～-1．19，P〈0．05），术后进食更早（WMD=-2．62，95％CI：-2．69～-2．55，P〈0．05），术后住院时间缩短（WMD=-1．63，95％CI：-1．92～-1．34，P〈0．05），术后并发症发生率降低（OR=0．52，95％CI：0．41～0．67，P〈O．05）；但两组术后再入院率的差异无统计学意义（P〉0．05）。结论FTS理念应用于腹腔镜结直肠癌根治术，可有效促进术后肠功能恢复，减少并发症的发生，缩短住院时间。

Systemic review of fast-track surgery in patients undergoing laparoscopic colorectal resection

Objective To evaluate the efficacy and safety of fast track surgery（Frs） in patients undergoing laparoseopic colorectal resection. Method Randomized controlled trials （RCT） or clinical controlled trials（CCT） on fast-track surgery in patients undergoing laparoscopic colorectal resection were obtained from databases including CNKI, Wanfang, PubMed, EMBACE, and Cochrane Library between January 2000 and March 2012. Meta-analysis was performed with RevMan 5.1. Result There were 6 RCTs and 7 CCTs including 1795 patients. There were 955 patients in the FTS group and 840 in the control group. The time to passage of flatus was shorter （WMD=-l.37, 95%CI：-1.55～-1.19, P〈 0.05）, time to resumption of diet/drink was shorter （WMD=-2.62, 95%CI：-2.69～-2.55, P〈0.05）, length of postoperative hospital stay was decreased （WMD=-l.63, 95%CI：-1.92～-1.34, P〈0.05） and the incidence of postoperative complications were less （0R=0.52, 95%CI：0.41～0.67, P〈O.05） in the FTS group. However, there were no differences in readmission （P〉0.05）. Conclusion Fast-track surgery in patients undergoing laparoscopic colorectal resection can promote bowel function recovery, decrease the incidence of postoperative complications and length of hospital stay.