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在完全的快速康复方案中,小肠、右半结肠或左半结肠切除并吻合术后胃肠道恢复需要多长时间?

How long for gastrointestinal recovery following small bowel, right, or left colonic resection with anastomosis in a full fast-track recovery protocol?

作者信息

Faucheron Jean-Luc, Vincent Damien, Barbut Mihaela, Jacquet-Perrin Isabelle, Sage Pierre-Yves, Foote Alison, Quesada Jean-Louis, Trilling Bertrand, Tidadini Fatah

机构信息

UMR 5525, University Grenoble Alpes, CNRS, Grenoble INP, TIMC, VetAgro Sup, 38000, Grenoble, France.

Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France.

出版信息

Int J Colorectal Dis. 2025 Apr 14;40(1):93. doi: 10.1007/s00384-025-04855-4.

Abstract

CONTEXT

Patients undergoing bowel resection with anastomosis experience postoperative impaired gastrointestinal motility, sometimes leading to symptoms such as nausea, vomiting, bloating, delayed passage of flatus and stools, and inability to tolerate solid food. We determined the times for recovery of gastrointestinal motility (in minutes) following intestinal resection with anastomosis.

METHODS

We used data from the MATRAC randomized clinical trial, a comparison between outcomes of a standard ERAS group and an ERAS plus massage group. 36 patients were randomized, 35 retained in the study (standard ERAS n = 16; ERAS plus massage n = 19).

RESULTS

Solid foods are tolerated after a median of about 3 h after small bowel resection, and medians of approximately 16 and 14 h after right and left colon resection, respectively. The first flatus appeared approximately 16, 44 and 17 h after resection of the small bowel, right colon and left colon, respectively. In other words, first flatus is expected during the first postoperative day following small bowel and left colon resection, and during the second postoperative day following right colon resection. The first stool appears approximately 36, 70 and 46 h after small bowel, right colon and left colon resection, respectively.

CONCLUSION

We found that the shortest recovery time was observed following small bowel resection, and the longest in patients who underwent right colectomy. The same evolution was observed for the resumption of flatus, defecation and solid food intake, taken separately.

摘要

背景

接受肠道切除吻合术的患者术后会出现胃肠动力受损,有时会导致恶心、呕吐、腹胀、排气和排便延迟以及无法耐受固体食物等症状。我们确定了肠道切除吻合术后胃肠动力恢复的时间(以分钟为单位)。

方法

我们使用了MATRAC随机临床试验的数据,该试验比较了标准加速康复外科(ERAS)组和ERAS加按摩组的结果。36例患者被随机分组,35例保留在研究中(标准ERAS组n = 16;ERAS加按摩组n = 19)。

结果

小肠切除术后约3小时中位数时间可耐受固体食物,右半结肠和左半结肠切除术后中位数时间分别约为16小时和14小时。小肠、右半结肠和左半结肠切除术后,首次排气分别约在术后16、44和17小时出现。换句话说,小肠和左半结肠切除术后预计在术后第一天出现首次排气,右半结肠切除术后在术后第二天出现。小肠、右半结肠和左半结肠切除术后,首次排便分别约在术后36、70和46小时出现。

结论

我们发现小肠切除术后恢复时间最短,右半结肠切除术患者恢复时间最长。单独来看,排气、排便和固体食物摄入恢复情况也呈现相同的变化趋势。

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本文引用的文献

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