快速康复外科理念在手助腹腔镜结直肠癌手术患者中的应用

目的探讨快速康复外科理念下围手术期处理方法在手助腹腔镜结直肠癌根治术中的应用价值。方法 2010年7月～2011年7月笔者所在科室对53例手助腹腔镜结直肠癌根治术患者应用快速康复外科理念围手术期处理(快速康复组),与同期55例按传统方法处理的开放手术患者(传统方法组)作对比。比较两组患者手术安全性、术后住院时间、恢复肠排气时间、停止静脉输液时间、治疗费用以及两组术后并发症的发生情况。结果两组手术时间、术后并发症的发生率、治疗费用等,差异均无统计学意义(P>0.05)。但快速康复组术中出血量减少、切口长度减短,术后住院时间缩短,术后首次肠道排气时间、停止静脉输液时间提前,差异均有统计学意义(P<0.05)。结论手助腹腔镜结直肠癌根治术患者应用快速康复外科围手术期处理方案安全、有效,有利于患者术后器官功能的早期康复,其临床应用前景广阔。

Concept of fast track surgery applied in patients undergoing hand-assisted laparoscopic operation for colorectal carcinoma

Objective To evaluate the application value of fast track surgery in hand-assisted laparoscopic radical resection of colorectal carcinoma.Methods From July 2010 to July 2011,108 patients undergoing colorectal surgery were included in this study.52 patients undergoing hand-assisted laparoscopy received perioperative fast track rehabilitation;meanwhile other 55 patients undergoing open surgery received conventional perioperativec care.Patient safety,length of postoperative hospital stay,medical cost,gut function,and post operative complication were compared between the two groups.Results There were no differences in operative time,medical cost,post operative complication between the two groups.Fast track rehabilitation group was associated with a significantly shorter postoperative hospital stay,less blood lose,shorter length of incision,earlier first passage of flatus compared with conventional care group.Conclusion Fast track rehabilitation was feasible and effective in hand-assisted laparoscopic operation for colorectal carcinoma.It can promote an early recovery and has broad application prospects in hand-assisted laparoscopic operation for colorectal carcinoma.