通过快速康复护理计划的修改进一步缩短腹腔镜结肠切除术的住院时间。

Further reduction of hospital stay for laparoscopic colon resection by modifications of the fast-track care plan.

机构信息

Department of Surgery, University of Illinois College of Medicine at Peoria, 624 Glen Oak Ave., Peoria, IL 61603, USA.

出版信息

Am J Surg. 2010 Mar;199(3):391-4; discussion 394-5. doi: 10.1016/j.amjsurg.2009.09.009.

DOI:10.1016/j.amjsurg.2009.09.009

PMID:20226917

Abstract

BACKGROUND

Fast-track surgery has been described as a plan to facilitate early recovery. We present one surgeon's modifications to fast-track surgery for laparoscopic colectomy patients.

METHODS

We performed a retrospective review of 48 consecutive patients undergoing elective laparoscopic colectomy treated by a modified fast-track plan between 2004 and 2008. Elements included preoperative education, pre-anesthesia dexamethasone, immediate postoperative general diet, no urinary catheter, no epidural anesthesia, and no flatus or bowel movement as a discharge requirement. Data collected included the following: age, sex, body mass index, resection indications, surgical time, blood loss, pain score, time to ambulation, time to bowel function, length of stay, complications, and mortality.

RESULTS

The mean length of stay was 37 hours (1.5 d), with 29 of 48 patients discharged without passage of flatus or stool. Only 1 patient required readmission.

CONCLUSIONS

Our modified fast-track plan achieved significant improvement in length of stay for laparoscopic colectomy compared with previous results.

摘要

背景

快速康复外科被描述为一种促进早期康复的方案。我们介绍一位外科医生对腹腔镜结肠切除术患者的快速康复外科的改进。

方法

我们对 2004 年至 2008 年间接受改良快速康复计划治疗的 48 例择期腹腔镜结肠切除术患者进行了回顾性研究。元素包括术前教育、麻醉前地塞米松、术后立即给予普通饮食、不使用导尿管、不使用硬膜外麻醉以及不需要排气或排便即可出院。收集的数据包括：年龄、性别、体重指数、切除指征、手术时间、出血量、疼痛评分、活动时间、肠道功能恢复时间、住院时间、并发症和死亡率。