Smedh K, Strand E, Jansson P, Iversen A M, Matti-Andersson A, Johansson H, Wall I
Kolorektalsektionen, kirurgkliniken samt operationskliniken, Centrallasarettet, Västerås.
Lakartidningen. 2001 May 23;98(21):2568-74.
By using a multimodal rehabilitation program professor Kehlet has shown accelerated recovery after colonic surgery with hospital stay of only two days, irrespective of open or laparoscopic technique. These results have not been confirmed in other studies. The aim of this study was to replace our traditional approach with Kehlet's multimodal regimen and try to reproduce his reported data.
22 patients (median age 67 years) underwent right- or leftsided colectomies, 15 open (7 with midline incisions) and 7 laparoscopically. Continuous thoracic epidural, immediate mobilization and oral nutrition were used. Discharge was planned three days after surgery. On the first postoperative day all had oral intake and on the third day patients were mobilized for a median of 9.7 hours and all had resumed defecation. Pain and fatigue scores (VAS) were low. The median post-operative hospital stay was 3.5 (range 3-8) days. Two patients returned with complications. No cardiopulmonary or infectious complications were seen. The multimodal rehabilitation programme resulted in a quick recovery and a hospital stay of three days in most patients after colonic surgery.
通过采用多模式康复方案，凯莱特教授已证明结肠手术后恢复加速，住院时间仅为两天，无论采用开放手术还是腹腔镜手术技术。其他研究尚未证实这些结果。本研究的目的是用凯莱特的多模式方案取代我们的传统方法，并尝试重现他报告的数据。
22例患者（中位年龄67岁）接受了右侧或左侧结肠切除术，15例为开放手术（7例采用中线切口），7例为腹腔镜手术。采用持续胸段硬膜外麻醉、早期活动和口服营养。计划术后三天出院。术后第一天所有患者均有口服摄入，第三天患者活动时间中位数为9.7小时，且均已恢复排便。疼痛和疲劳评分（视觉模拟评分法）较低。术后中位住院时间为3.5天（范围3 - 8天）。两名患者因并发症返回。未观察到心肺或感染性并发症。多模式康复方案使大多数结肠手术后患者恢复迅速，住院时间为三天。
