Objective To investigate the advantage and safety of the concept of fast- track surgery (FTS) applied in perioperative patients with biliary calculi and liver cirrhosis. Methods Fifty- two patients undergoing operation for biliary calculi and liver cirrhosis from January2011 to September 2013 were included in this study. These patients were randomly divided into FTS group ( n = 30) and control group (n = 22) . Patients in the FTS group received perioperative care measures guided by FTS concept, while patients in the control group received traditional perioperative management measures. The intraoperative situation of patients, time to postoperative recovery of intestinal function, length of postoperative hospital stay, total medical expenses during hospitalization, and postoperative complications were compared between the two groups. Continuous data and categorical data were compared by t- test and χ2test, respectively. Results As compared with the control group, the FTS group had significantly time to postoperative recovery of intestinal function ( t = 2. 239, P = 0. 045) , a significantly shortened length of postoperative stay (t = 4. 246, P = 0. 038) , and significantly reduced total medical expenses during hospitalization (t = 3. 045, P = 0. 033) . No significant difference in postoperative complications was observed between the two groups (P >0. 05) . Conclusion The concept of FTS can be safely and effectively applied in perioperative patients with biliary calculi and liver cirrhosis, which can accelerate rehabilitation without increasing the risk of surgery.
[1]WILMORE DW, KEHLET H.Management of patients in fast track surgery[J].BMJ, 2001, 322 (7284) :473-476.
|
[2]LIANG YR, XIANG BD.Application of concept of fast-track surgery in perioperative period of primary liver cancer[J].Chin J Oncol Prev Treat, 2014, 6 (1) :93-95. (in Chinese) 梁泳荣, 向邦德.快速康复外科理念在原发性肝癌围手术期的应用[J].中国癌症防治杂志, 2014, 6 (1) :93-95.
|
[3]LI N, YU L, YANG JH, et al.Influence and treatment of liver cirrhosis on abdominal surgery[J].Chin J Curr Adv Gen Surg, 2012, 15 (5) :389-391. (in Chinese) 李宁, 喻莉, 杨军辉, 等.肝硬化对腹部手术的影响分析及处理[J].中国现代普通外科进展, 2012, 15 (5) :389-391.
|
[4]JANG HJ, KIM JH, SONG HH, et al.Clinical outcmes patients with liver cirrhosis who underwent curative surgery for gastric cancer:aretrospective multi-center study[J].Dig Dis Sci, 2008, 53 (2) :399-404.
|
[5]JIANG ZW, LI JS.Perioperative management guided by theory of fast-track surgery[J].J Abdominal Surg, 2009, 22 (5) :305-306. (in Chinese) 江志伟, 黎介寿.快速康复外科理论指导下的围手术期处理[J].腹部外科, 2009, 22 (5) :305-306.
|
[6]WANG JG, GAO JT, LI QH, et al.Analysis of clinical applied effect on the concept of fast track surgery in bilioenteric anastomosis[J].J Hepatopancreatobiliary Surg, 2012, 24 (2) :103-105, 109. (in Chinese) 王建国, 高静涛, 李庆怀, 等.快速康复外科理念在胆肠吻合术中的临床应用效果分析[J].肝胆胰外科杂志, 2012, 24 (2) :103-105, 109.
|
[7]CHI MH, ZENG YY, LIU JF.Fast-track surgical treatment of liver cancer patients through liver resection within the perioperative period[J].Chin J Clin Oncol, 2012, 39 (23) :1939-1942. (in Chinese) 池闽辉, 曾永毅, 刘景丰.快速康复外科在肝癌肝切除围手术期的应用研究[J].中国肿瘤临床, 2012, 39 (23) :1939-1942.
|
[8]DING W, ZHANG F, LI GQ, et al.Application of fast track surgery in perioperative management of patients with hepatic cancer[J].Chin J Gen Surg, 2013, 22 (1) :32-36. (in Chinese) 丁蔚, 张峰, 李国强, 等.快速康复理念在肝癌肝切除术围手术期处理中的应用[J].中国普通外科杂志, 2013, 22 (1) :32-36.
|
[9]GUSTAFSSON UO, LJUNGQVIST O.Perioperative nutritional management in digestive tract surgery[J].Curr Opin Clinnutr Metab Care, 2011, 14 (5) :504-509.
|
[10]KHALID I, DOSHI P, DIGIOVINE B.Early enteral nutrition and outcomes of critically ill patients treated with vasopressors and mechanical ventilation[J].Am J Crit Care, 2010, 19 (5) :261-268.
|
[11]RAO JH, LYU L, WANG P, et al.The study on the application of abdominal draiage after liver resection[J].Chin J Gen Surg, 2010, 25 (4) :303-305. (in Chinese) 饶建华, 吕凌, 王平, 等.腹腔引流术在肝脏切除术后应用的必要性探讨[J].中华普通外科杂志, 2010, 25 (4) :303-305.
|
[12]SHI WD, LYU L, ZHANG CY, et al.Safety of liver transplantation without intra-abdominal drainage[J].Organ Transplant, 2011, 2 (3) :149-151, 174. (in Chinese) 施卫东, 吕凌, 张传永, 等.肝移植术后不放置腹腔引流管的安全性评价[J].器官移植, 2011, 2 (3) :149-151, 174.
|