Marx Charlotte, Rasmussen Tina, Jakobsen Dorthe Hjort, Ottosen Christian, Lundvall Lene, Ottesen Bent, Callesen Torben, Kehlet Henrik
Department of Gynecology, The Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Denmark.
Acta Obstet Gynecol Scand. 2006;85(4):488-92. doi: 10.1080/00016340500408325.
In patients undergoing colonic surgery the postoperative hospital stay has been reduced from 8-12 days to 2-4 days with multimodal rehabilitation programs. The aim of this study was to evaluate the postoperative outcome after surgery for ovarian malignancy with conventional care compared to fast-track multimodal rehabilitation.
Seventy-two consecutive patients receiving conventional care (group 1) were compared with 69 consecutive patients receiving multimodal, fast-track rehabilitation with a planned care program including continuous epidural analgesia, early oral feeding and mobilization (group 2) in the same department. Outcome was postoperative hospital stay and morbidity during the first postoperative month.
Median age was 63 years (group 1) and 62 years (group 2). Median postoperative hospital stay was reduced from 6 days in group 1 (mean 7.3) to 5 days in group 2 (mean 5.4) (p < 0.05). There was no difference in the overall complication rate, although severe medical complications were reduced in group 2 (14% versus 2%; p < 0.01). Readmission rate was 10% in group 1 and 3% in group 2 (p > 0.05).
The concept of fast-track multimodal rehabilitation appears to be beneficial in patients operated for ovarian malignancy, as hospital stay and medical morbidity are reduced.
在接受结肠手术的患者中，多模式康复计划已将术后住院时间从8 - 12天缩短至2 - 4天。本研究的目的是评估与快速康复多模式康复相比，传统护理方式下卵巢恶性肿瘤手术后的术后结局。
将同一科室连续接受传统护理的72例患者（第1组）与连续接受多模式快速康复且有包括持续硬膜外镇痛、早期经口进食和活动的计划护理方案的69例患者（第2组）进行比较。结局指标为术后住院时间和术后第一个月内的发病率。
第1组的中位年龄为63岁，第2组为62岁。第1组的中位术后住院时间从6天（平均7.3天）降至第2组的5天（平均5.4天）（p < 0.05）。总体并发症发生率无差异，尽管第2组的严重医疗并发症有所减少（14%对2%；p < 0.01）。第1组的再入院率为10%，第2组为3%（p > 0.05）。
快速康复多模式康复理念似乎对接受卵巢恶性肿瘤手术的患者有益，因为住院时间和医疗发病率均有所降低。
