Hasenberg T, Rittler P, Post S, Jauch K W, Senkal M, Spies C, Schwenk W, Shang E
Chirurgische Klinik, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Chirurg. 2007 Sep;78(9):818-26. doi: 10.1007/s00104-007-1354-0.
Despite the evidence that fast-track concepts in colon surgery lead to an enhanced recovery rate, there is no information on the prevalence and utilization of such programs in Germany.
Based on a conventional sigmoid resection, we asked 1,270 surgical departments in Germany to describe their standard surgical procedures in a questionnaire.
The response rate was 385 (30.31%). A total of 96% use a bowel preparation, 83% a vertical incision, 10% use a nasogastric decompression for longer then 1 day, 34% avoid intra-abdominal drains, 51% allow clear fluids on the day of surgery, 13% offer solid food on the first day after surgery, 75% use epidural analgesia and 47% discharge the patients by the seventh day after surgery.
Although there is an evident benefit using fast-track concepts, they are not yet in wide use as a standard procedure. Further efforts have to be made to ensure that the majority of patients will benefit from these concepts.
尽管有证据表明结肠手术中的快速康复理念可提高康复率,但德国此类方案的普及率和应用情况尚无相关信息。
基于传统乙状结肠切除术,我们向德国1270个外科科室发放问卷,询问其标准手术流程。
回复率为385(30.31%)。共有96%的科室采用肠道准备,83%采用纵行切口,10%使用鼻胃减压超过1天,34%避免放置腹腔引流管,51%允许患者在手术当天饮用清流质,13%在术后第一天提供固体食物,75%使用硬膜外镇痛,47%在术后第七天让患者出院。
尽管快速康复理念有明显益处,但尚未作为标准程序广泛应用。必须进一步努力确保大多数患者能从这些理念中受益。