Gralla O, Buchser M, Haas F, Anders E, Kramer J, Lein M, Knoll N, Roigas J
Klinik für Urologie, Klinikum der Universität zu Köln, Kerpener Strasse 62, Köln, Germany.
Urologe A. 2008 Jun;47(6):712-7. doi: 10.1007/s00120-008-1688-3.
Fast-track surgery describes perioperative treatment concepts ensuring a faster postoperative convalescence phase. By using a multimodal fast-track concept in patients undergoing laparoscopic radical prostatectomy, we aimed to investigate the feasibility of this procedure after elective surgery and a possible discharge 3 days postoperatively.
Twenty-five patients per group were randomized for conventional or fast-track treatment, respectively. Perioperative data, early complications, possible hospital discharge, and readmission rate were analyzed. Before hospital discharge, all patients were interviewed about their evaluation of the received regimen and their overall satisfaction perioperatively.
The mean postoperative hospital stay was 3.6 days in the fast-track group vs. 6.7 days in the conventional group (p<0.01). Overall complications were low but were significant between the two groups, with the fast-track procedure being more favorable. Readmission rate was also low but was not significant. Overall satisfaction was significantly higher in the fast-track group, whereas the subjective evaluation did not differ between the two regimens.
Fast-track concepts are well transferable in laparoscopic radical prostatectomy settings. Patients receiving this procedure, as well as clinics offering it, may benefit from a suitable fast-track concept.
快速康复外科描述了确保术后康复期更快的围手术期治疗理念。通过在接受腹腔镜根治性前列腺切除术的患者中采用多模式快速康复理念，我们旨在研究该手术在择期手术后及术后3天可能出院的可行性。
每组25例患者分别随机接受传统治疗或快速康复治疗。分析围手术期数据、早期并发症、可能的出院情况及再入院率。在出院前，对所有患者就其对所接受治疗方案的评估及其围手术期总体满意度进行访谈。
快速康复组术后平均住院时间为3.6天，而传统组为6.7天（p<0.01）。总体并发症发生率较低，但两组之间存在显著差异，快速康复手术更为有利。再入院率也较低，但无显著差异。快速康复组的总体满意度显著更高，而两种治疗方案的主观评估无差异。
快速康复理念在腹腔镜根治性前列腺切除术环境中易于应用。接受该手术的患者以及提供该手术的诊所可能会从合适的快速康复理念中受益。
