Zhu Hongping, Xu Xiaoying
Hongping Zhu Department of Obstetrics and Gynecology, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, No. 39 Xiashatang, Mudu Town, Wuzhong District, Suzhou City, Jiangsu Province 215101, China.
Xiaoying Xu Department of Obstetrics and Gynecology, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, No. 39 Xiashatang, Mudu Town, Wuzhong District, Suzhou City, Jiangsu Province 215101, China.
Pak J Med Sci. 2024 Aug;40(7):1326-1331. doi: 10.12669/pjms.40.7.9117.
This study aimed to compare fast-track surgery (FTS) and traditional perioperative care protocols in laparoscopic gynecological surgeries, assessing their impact on length of stay (LOS), recovery time, and postoperative complications.
A case-control retrospective study was conducted at Suzhou Hospital of Integrated Chinese and Western Medicine, involving 167 patients undergoing laparoscopic gynecological surgery from June 2021 to June 2023. Of them, 81 patients underwent surgery based on the FTS protocol (FTS group) and 86 patients received a traditional perioperative management (control group). Patients in both groups underwent gynecologic laparoscopic procedures, including uterine, ovarian and tubal surgeries. Data were collected on general patients' characteristics, including age, BMI, surgery type and time, intestinal recovery and out-of-bed activity time, LOS, pain levels, and postoperative complications. Wilcoxon rank sum test with continuity correction was used to assess the difference in operative characteristics and postoperative pain levels. Fisher's exact test was used to assess the difference in overall frequency of postoperative complications between groups.
Patients in the FTS group exhibited faster intestinal recovery, shorter mobilization time, and reduced LOS compared to the control group. Pain levels were significantly lower at one, six and twelve hours post-surgery in the FTS group. Overall, the proportion of postoperative complications was significantly lower in the FTS group than in the control group.
Implementing the FTS protocol in laparoscopic gynecological surgeries for benign conditions can reduce LOS, accelerate recovery, and minimize pain without increasing postoperative complications. Further research with more diverse patient populations is warranted to validate these findings.
本研究旨在比较快速康复外科（FTS）与传统围手术期护理方案在妇科腹腔镜手术中的应用效果，评估它们对住院时间（LOS）、恢复时间和术后并发症的影响。
在苏州市中西医结合医院进行了一项病例对照回顾性研究，纳入了2021年6月至2023年6月期间接受妇科腹腔镜手术的167例患者。其中，81例患者接受基于FTS方案的手术（FTS组），86例患者接受传统围手术期管理（对照组）。两组患者均接受妇科腹腔镜手术，包括子宫、卵巢和输卵管手术。收集了患者的一般特征数据，包括年龄、体重指数、手术类型和时间、肠道恢复和下床活动时间、LOS、疼痛程度和术后并发症。采用连续性校正的Wilcoxon秩和检验评估手术特征和术后疼痛程度的差异。采用Fisher精确检验评估两组术后并发症总体发生率的差异。
与对照组相比，FTS组患者肠道恢复更快，活动时间更短，LOS更短。FTS组术后1小时、6小时和12小时的疼痛程度明显更低。总体而言，FTS组术后并发症的比例明显低于对照组。
在良性疾病的妇科腹腔镜手术中实施FTS方案可减少LOS，加速恢复，减轻疼痛，且不增加术后并发症。需要对更多样化的患者群体进行进一步研究以验证这些发现。
