Department of Urology, Charité University Medicine, Campus Mitte, Berlin, Germany.
J Endourol. 2011 Jul;25(7):1143-7. doi: 10.1089/end.2011.0020.
Postoperative recovery of intestinal function, ability to ambulate, and effective pain management are main features to establish an effective fast-track surgery model. We investigated pain scores, ambulation rate, and recovery of intestinal function in a cohort of patients who were undergoing laparoscopic radical prostatectomy (LRP).
Fifty patients who underwent LRP in our institution were randomized to receive either conventional or fast-track postoperative care. Postoperative intestinal function was quantified by clinical signs of intestinal motility. Ambulation data were collected by means of step-count devices. Pain scores were measured by a visual analog scale. Overall satisfaction and additional measures to describe patient satisfaction with the clinical course were used as quality-of-life variables.
Fast-track patients had significantly earlier propulsive intestinal motility without increased intestinal complications. Enforced mobilization led to a significantly shorter period to first deflation/defecation. Despite significantly increased ambulation rates in the fast-track group, these patients reported significantly less pain sentience during a significantly shorter hospital stay. Overall satisfaction was significantly higher in the fast-track cohort during the hospital stay.
With the implementation of fast-track concepts for LRP, patients can be discharged to home earlier with fewer complications, lower pain scores, and an overall higher satisfaction with life.
术后肠道功能恢复、活动能力和有效止痛是建立有效快速康复外科模式的主要特征。我们研究了接受腹腔镜根治性前列腺切除术（LRP）的患者的疼痛评分、活动率和肠道功能恢复情况。
在我院接受 LRP 的 50 名患者被随机分为接受常规或快速康复术后护理。通过肠道动力的临床征象来量化术后肠道功能。通过计步器收集活动数据。使用视觉模拟评分法测量疼痛评分。整体满意度和其他描述患者对临床过程满意度的措施作为生活质量变量。
快速康复组患者的推进性肠道动力明显更早，而肠道并发症没有增加。强制性活动导致首次排气/排便的时间明显缩短。尽管快速康复组的活动率明显增加，但这些患者在住院期间报告的疼痛感知明显减轻，住院时间明显缩短。在住院期间，快速康复组的整体满意度明显更高。
通过实施 LRP 的快速康复理念，患者可以更早地出院，并发症更少，疼痛评分更低，整体生活满意度更高。
