将科学证据应用于日常实践——以快速康复结肠癌手术为例。
Implementation of the scientific evidence into daily practice--example from fast-track colonic cancer surgery.
作者信息
Hammer J, Harling H, Wille-Jørgensen P
机构信息
Department of Surgery K, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
出版信息
Colorectal Dis. 2008 Jul;10(6):593-8. doi: 10.1111/j.1463-1318.2007.01469.x. Epub 2008 Mar 3.
OBJECTIVE
To report the implementation and results of fast-track surgery for colonic cancer in the daily routine.
METHOD
A total of 131 consecutive patients scheduled for elective colonic cancer resections entered a fast-track perioperative course after thorough information. The regimen contained: no preoperative bowel cleansing, transverse and small abdominal incisions, no drains nor tubes, mobilization and normal meal the evening on the day of surgery, epidural analgesia, oral laxatives, and a planned discharge on postoperative day 3.
RESULTS
Median number of days postoperative in hospital were 4 days (range 1-46). Eighty-nine per cent experienced an uncomplicated course, 3% were readmitted within 30 days, and the 30-day mortality was 3.8%.
CONCLUSION
Fast-track surgery is feasible in an unselected patient population scheduled for elective colon cancer resections without compromising quality.
目的
报告在日常临床中结肠癌快速康复外科的实施情况及结果。
方法
131例连续计划择期行结肠癌切除术的患者在充分了解相关信息后进入快速康复围手术期流程。该方案包括：不进行术前肠道准备，采用横切口及小腹部切口，不放置引流管，手术当天晚上即可活动并正常进食，采用硬膜外镇痛，口服泻药，并计划在术后第3天出院。
结果
术后住院天数中位数为4天（范围1 - 46天）。89%的患者病程顺利，3%的患者在30天内再次入院，30天死亡率为3.8%。
结论
对于计划择期行结肠癌切除术的未经过挑选的患者群体，快速康复外科是可行的，且不影响手术质量。
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