Baird Gayle, Maxson Pamela, Wrobleski Diane, Luna Barbara S
General Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Clin Nurse Spec. 2010 Jul-Aug;24(4):202-8. doi: 10.1097/NUR.0b013e3181e3604c.
This study compared outcomes of a fast-track postoperative program implemented for patients undergoing laparoscopic colorectal surgery on 2 surgical units to patients receiving traditional postoperative care following laparoscopic colorectal surgery prior to implementation of the fast-track program.
The primary aim was to determine if there was a significant difference in length of stay and 30-day readmission rates between the 2 groups. The secondary aim was to examine whether patients on the fast-track program were able to successfully tolerate early diet, early ambulation, and minimal use of drains.
The study was conducted at a large Midwestern hospital.
A retrospective medical record review was done on 100 patients who underwent laparoscopic colorectal surgery on the fast-track program for data pertaining to the research questions. Additionally, a medical record review was done for comparison on 100 matched controls based on age, sex, surgeon, and surgical procedure who received traditional postoperative care following laparoscopic colorectal surgery.
A statistical significant difference of 1 day was found between patients receiving traditional care and patients on the fast-track program. Readmission rates between the 2 groups were not statistically significantly different.
: Overall, patients undergoing laparoscopic colorectal surgery on a fast-track program discharged 1 day sooner than patients on traditional recovery programs. Patients successfully followed the fast-track program.
Fast-track programs in colorectal surgery reduce length of stay and could be considered for other surgical populations.
本研究比较了在两个手术科室为接受腹腔镜结直肠手术的患者实施的快速康复术后方案与在快速康复方案实施前接受腹腔镜结直肠手术传统术后护理的患者的治疗结果。
主要目标是确定两组患者的住院时间和30天再入院率是否存在显著差异。次要目标是检查接受快速康复方案的患者是否能够成功耐受早期饮食、早期活动以及尽量少用引流管。
该研究在一家位于中西部的大型医院进行。
对100例接受快速康复方案的腹腔镜结直肠手术患者的病历进行回顾性审查,以获取与研究问题相关的数据。此外,对100例根据年龄、性别、外科医生和手术方式匹配的对照组患者的病历进行回顾性审查,这些患者在接受腹腔镜结直肠手术后接受传统术后护理。
接受传统护理的患者与接受快速康复方案的患者之间存在1天的统计学显著差异。两组之间的再入院率无统计学显著差异。
总体而言,接受快速康复方案的腹腔镜结直肠手术患者比接受传统康复方案的患者提前1天出院。患者成功遵循了快速康复方案。
结直肠手术的快速康复方案可缩短住院时间,其他手术人群也可考虑采用。