Khripun A I, Sazhin I V, Shurygin S N, Makhuova G B
Department of Surgery and Endoscopy Faculty of Additional Professional Education, Pirogov Russian National Research Medical University, Moscow, Russia, Buyanov Municipal Clinical Hospital of Moscow Healthcare Department, Moscow, Russia.
Khirurgiia (Mosk). 2018(6):58-61. doi: 10.17116/hirurgia2018658-61.
To analyze the outcomes of fast track rehabilitation program in patients with perforated duodenal ulcer (PDU).
For the period 2013-2016 at the Department of Surgery and Endoscopy 206 PDU patients have been treated. Inclusion criterion for the main group (n=77) was duodenal ulcers, their dimension up to 1 cm, laparoscopic suture of perforated ulcer, fast track rehabilitation program implementation. The control group consisted of 129 patients who underwent open suturing of perforated ulcer followed by conventional treatment in postoperative period.
In the main group (n=77) laparoscopic suturing of ulcerative defect with the use of Fast Track program was performed. Postoperative complication i.e. sutures failure was observed in 1 (1.3%) case. There were no lethal outcomes in the main group. Mean length of hospital-stay was 4.8 days. In 129 patients of the control group open suturing of the perforated ulcer and conventional postoperative therapy were applied. Postoperative surgical complications were absent in the control group; mortality rate was 2.3%. Mean length of postoperative hospital-stay was 8.1 days.
Laparoscopic treatment of perforated ulcers facilitates application of fast track rehabilitation program in emergency patients. Fast track rehabilitation protocol after laparoscopic suturing of the perforated ulcer creates conditions for early discharge and is followed by good clinical and economic effects. Recurrent peptic ulcers are noted if antiulcer therapy is absent.
分析快速康复计划在十二指肠溃疡穿孔（PDU）患者中的治疗效果。
2013年至2016年期间，外科与内窥镜科共治疗了206例PDU患者。主要组（n = 77）的纳入标准为十二指肠溃疡，溃疡大小达1厘米，采用腹腔镜缝合穿孔溃疡，并实施快速康复计划。对照组由129例患者组成，这些患者接受了穿孔溃疡的开放缝合术，术后进行常规治疗。
主要组（n = 77）采用快速康复计划进行了溃疡性缺损的腹腔镜缝合。观察到1例（1.3%）术后并发症，即缝线失败。主要组无死亡病例。平均住院时间为4.8天。对照组的129例患者接受了穿孔溃疡的开放缝合及常规术后治疗。对照组无术后手术并发症；死亡率为2.3%。术后平均住院时间为8.1天。
腹腔镜治疗穿孔性溃疡有助于在急诊患者中应用快速康复计划。穿孔性溃疡腹腔镜缝合术后的快速康复方案为早期出院创造了条件，并具有良好的临床和经济效益。若不进行抗溃疡治疗，则会出现复发性消化性溃疡。
