快速康复外科在腹腔镜直肠癌手术中的应用体会

目的:探讨在快速康复外科(fast track surgery,FTS)指导下行腹腔镜直肠癌手术的安全性与可行性。方法:将90例直肠癌患者随机分为两组,每组45例,A组应用FTS处理措施行开腹手术;B组采用FTS处理措施行腹腔镜手术。比较两组首次排气时间、住院时间、住院费用、并发症及再住院率等指标。结果:两组术后首次排气时间、住院时间差异无统计学意义(P>0.05)。B组住院费用更高,差异有统计学意义(P<0.05)。两组并发症发生率差异无统计学意义(P>0.05)。A组再入院率(2.2%)低于B组(4.4%),但差异无统计学意义(P>0.05)。结论:FTS指导下的腹腔镜直肠癌手术可促进胃肠蠕动、缩短术后住院时间,且不增加术后并发症及再住院率,但与FTS指导下的开腹直肠癌手术相比,优势并不十分明显。

Clinical application of fast track surgery in patients undergoing laparoscopic operation for rectal cancer

Objective：To investigate the safety and feasibility of fast track surgery（FTS） in patients undergoing laparoscopic operation for rectal cancer. Methods：Ninety patients with rectal cancer were randomly divided into 2 groups. Every group had 45 patients. Group A received FTS combined with open surgery. Group B received FTS combined with laparoscopic surgery. The first time of flatus,the postoperative hospital stay,the hospitalization cost,postoperative complications and rehospitalization rate between the 2 groups were compared. Results：Compared with group A,the first time of flatus and the length of postoperative hospital stay of group B were not statistically significantly different（P〉0. 05）. The medical cost of group B was higher（P〈0. 05）. There was no significant difference in the incidence of postoperative complications between the 2 groups（P〉0. 05）. Group A＇s rehospitalization rate（2. 2%） was lower than group B（4. 4%）,but there was no statistically significant difference（P〉0. 05）. Conclusions：Laparoscopic operation for rectal cancer guided by FTS could accelerate gastrointestinal peristalsis,shorten postoperative hospital stay and does not increase postoperative complications and rehospitalization rate. But the advantage is limited compared with open rectal cancer surgery guided by FTS.