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快速康复腹腔镜手术:治疗结直肠癌比传统腹腔镜手术更好的选择。

Fast-track laparoscopic surgery: A better option for treating colorectal cancer than conventional laparoscopic surgery.

作者信息

Taupyk Yerlan, Cao Xueyuan, Zhao Yinquan, Wang Chao, Wang Quan

机构信息

Department of Gastric and Colorectal Surgery, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.

出版信息

Oncol Lett. 2015 Jul;10(1):443-448. doi: 10.3892/ol.2015.3166. Epub 2015 Apr 29.

Abstract

Fast-track surgery (FTS), a multimodal rehabilitation technique, has been recommended as surgical therapy for colorectal cancer. The objective of the present study was to compare the outcomes of FTS and conventional laparoscopic surgery. This study was a blinded randomized trial. A total of 70 patients with colorectal cancer were divided into two groups and underwent laparoscopic colorectal resection. The FTS group consisted of 31 patients and the control group consisted of 39 patients. Protocols for the treatment of the FTS group included skipping pre-operative mechanical bowel preparation, early restoration of diet and early post-operative ambulation. Outcome measures, length of hospital stay, post-operative surgical stress response [C-reactive protein (CRP)] and post-operative complications were compared between the two groups. The average length of total hospital stay for the FTS and the control groups was 5.9±0.8 and 10.9±1.3 days, respectively (P<0.05), and the length of post-operative hospital stay for the FTS and control group was 4.3±0.8 and 8.0±1.1 days, respectively. (P<0.05) First flatus time for the FTS and control groups was 1.6±0.8 and 2.5±0.9 days, respectively (P<0.05). Defecation time for the FTS and control groups was 2.2±0.7 and 4.5±0.7 days, respectively (P<0.05). The time to restoration of a solid diet also showed a significant difference between the FTS and control groups (1.1±0.3 vs. 3.6±0.9 days; P<0.05). Following surgery, due to post-operative surgical stress, the two groups CRP levels increased significantly, but the levels of the FTS group were lower than those of the conventional control group (P<0.05). There was no difference in post-operative complications between the FTS and control groups. This study confirms that FTS shortens hospital stay and accelerates the recovery of bowel function without increase of post-operative complications. FTS is safe, improves post-operative recovery and is a better option than conventional laparoscopic surgery for treating colorectal cancer patients.

摘要

快速康复外科(FTS)是一种多模式康复技术,已被推荐用于结直肠癌的手术治疗。本研究的目的是比较FTS与传统腹腔镜手术的效果。本研究为双盲随机试验。总共70例结直肠癌患者被分为两组并接受腹腔镜结直肠切除术。FTS组有31例患者,对照组有39例患者。FTS组的治疗方案包括不进行术前机械肠道准备、早期恢复饮食和早期术后活动。比较两组的结果指标、住院时间、术后手术应激反应[C反应蛋白(CRP)]和术后并发症。FTS组和对照组的总住院平均时间分别为5.9±0.8天和10.9±1.3天(P<0.05),FTS组和对照组的术后住院时间分别为4.3±0.8天和8.0±1.1天(P<0.05)。FTS组和对照组的首次排气时间分别为1.6±0.8天和2.5±0.9天(P<0.05)。FTS组和对照组的排便时间分别为2.2±0.7天和4.5±0.7天(P<0.05)。恢复固体饮食的时间在FTS组和对照组之间也显示出显著差异(1.1±0.3天对3.6±0.9天;P<0.05)。手术后,由于术后手术应激,两组的CRP水平均显著升高,但FTS组的水平低于传统对照组(P<0.05)。FTS组和对照组在术后并发症方面没有差异。本研究证实,FTS可缩短住院时间并加速肠功能恢复,且不增加术后并发症。FTS是安全的,可改善术后恢复,是治疗结直肠癌患者比传统腹腔镜手术更好的选择。

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