Jianjun Qin, Yin Li, Wenqun Xing, Ming Yan, Qingfeng Jiang
Department of Thoracosurgery, Henan Tumor Hospital, Zhengzhou University, Zhengzhou, China.
Thorac Cancer. 2012 Feb;3(1):55-59. doi: 10.1111/j.1759-7714.2011.00081.x.
A fast track (FT) program for esophagectomy patients is rarely used. We streamlined care using an algorithm for the postoperative care of patients who underwent esophagectomy to try to reduce hospital stays to 7 days while maintaining safety and patient satisfaction.
A consecutive series of 80 patients with esophageal carcinoma who underwent elective esophageal resection from 2007 to 2008 in our department was taken into the FT program. An algorithm for FT to guide postoperative care was used, featuring avoidance of the intensive care unit, early ambulation, removal of nasogastric tube and oral nutrition starting on postoperative day (POD) 1, with discharge on POD 7.
All patients were operated upon through a left posterolateral thoracotomy with a cervical esophagogastrostomy. Seventy-eight (97.5%) patients completed the FT program. Discharge home was proposed for POD7. None was readmitted within 30 days of discharge. None suffered from anastomotic leakage. The time to first passage of flatus was 51.7 ± 8.4 h.
The majority of patients with esophageal carcinoma can tolerate FT surgery. Oral nutrition starting on POD1 is safe and FT surgery is feasible for patients scheduled for elective esophageal cancer resections without compromising quality.
食管癌切除患者的快速康复（FT）计划很少被采用。我们使用一种算法简化了食管癌切除术后患者的护理流程，试图在保证安全性和患者满意度的同时，将住院时间缩短至7天。
连续选取2007年至2008年在我科接受择期食管癌切除术的80例食管癌患者纳入FT计划。采用FT算法指导术后护理，特点是避免进入重症监护病房、早期活动、术后第1天拔除鼻胃管并开始口服营养，术后第7天出院。
所有患者均通过左后外侧开胸行颈部食管胃吻合术。78例（97.5%）患者完成了FT计划。建议术后第7天出院回家。出院后30天内无患者再次入院。无患者发生吻合口漏。首次排气时间为51.7±8.4小时。
大多数食管癌患者能够耐受FT手术。术后第1天开始口服营养是安全的，FT手术对于计划接受择期食管癌切除术的患者是可行的，且不影响质量。
