低位/超低位直腸癌快速流程模式的效果探討_《中國普外基礎與臨床雜志》

作者：

楊廷翰 ^1,2,3 , 周寅 ^1,2,3 , 余曦 ^1,2,3 , 郝晉 ^1,2,4 , 汪曉東 ^1,2 , 李立 ^1,2

1.四川大學華西醫院胃腸外科中心（成都 610041）;;
2.四川大學華西醫院MCQ團隊（成都 610041）;;
3.四川大學華西臨床醫學院/華西醫院（成都 610041）;;
4.四川大學華西口腔醫學院（成都 610041）;

關鍵詞：

直腸腫瘤快速流程加強康復流程低位前切除術

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的初步探討低位/超低位直腸癌快速流程模式的臨床效果。方法回顧性研究2007年10月至2008年12月期間四川大學華西醫院胃腸外科中心結直腸外科專業組收治的行未造口的根治性切除術的120例低位/超低位直腸癌患者的病例資料，分析快速流程管理模式下（快速流程組）與傳統管理模式下（傳統組）患者早期恢復情況。結果從術后早期康復指標來看，快速流程組的首次排氣時間、首次下床活動時間、首次經口進食時間、首次拔除尿管時間及術后住院時間均短于傳統組，差異有統計學意義（P lt;0.05）；而2組首次拔除胃管和引流管時間的差異則沒有統計學意義（P gt;0.05）。2組患者術后并發癥發生率的差異亦沒有統計學意義（P gt;0.05）。結論低位/超低位直腸癌快速流程模式具有良好的安全性，能夠促進患者早期康復、縮短住院時間。

引用本文： 楊廷翰,周寅,余曦,郝晉,汪曉東,李立. 低位/超低位直腸癌快速流程模式的效果探討. 中國普外基礎與臨床雜志, 2010, 17(6): 618-621. doi: 復制

1.	Kehlet H. Fast-track colorectal surgery [J]. Lancet， 2008; 371(9615): 791-793.
2.	汪曉東，謝堯，肖軍，等. 快速流程在結直腸外科手術后管理中的應用 [J]. 中國普通外科雜志， 2008； 17（4）： 394-396.
3.	Basse L, Thorbl JE, Lssl K, et al. Colonic surgery with accelerated rehabilitation or conventional care[J]. Dis Colon Rectum, 2004; 47(3): 271-277.
4.	Delaney CP, Zutshi M, Senagore AJ, et al. Prospective, randomized, controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection [J]. Dis Colon Rectum, 2003; 46(7): 851-859.
5.	Anderson AD, McNaught CE, MacFie J, et al. Randomized clinical trial of multimodal optimization and standard perioperative surgical care [J]. Br J Surg, 2003; 90(12): 1497-1504.
6.	King PM, Blazeby JM, Ewings P, et al. Randomized clinical trial comparing laparoscopic and open surgery for colorectal cancer within an enhanced recovery programme [J]. Br J Surg, 2006; 93(3): 300-308.
7.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 [J]. 中國普外基礎與臨床雜志, 2009; 16(5-8): 413, 493-494, 581, 671.
8.	Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery [J]. Lancet, 2003; 362(9399): 1921-1928.
9.	Maessen JM, Dejong CH, Kessels AG, et al. Length of stay: an inappropriate readout of the success of enhanced recovery programs [J]. World J Surg, 2008; 32(6): 971-975.
10.	肖凌，李蔚，麥玲，等. 快速流程模式下術后限制補液對不同手術方案直腸癌患者康復情況的影響 [J]. 中國普外基礎與臨床雜志， 2010； 17（2）： 190-194.
11.	李立. 結直腸癌外科應用技術的規范與創新（四） [J]. 中國普外基礎與臨床雜志， 2006； 13（4）： 461-468.
12.	周寅，楊廷翰，汪曉東，等. 早期經口進食在結直腸癌術后快速流程模式中的應用 [J]. 中國普外基礎與臨床雜志， 2010； 17(5): 500-503.
13.	Hasenberg T, Keese M, Lngle F, et al. ‘Fast-track’ colonic surgery in Austria and Germany-results from the survey on patterns in current perioperative practice [J]. Colorectal Dis, 2009; 11(2): 162-167.
14.	Nelson R, Edwards S, Tse B. Prophylactic nasogastric decompression after abdominal surgery[J]. Cochrane Database Syst Rev, 2007; (3): CD004929.
15.	Petrowsky H, Demartines N, Rousson V, et al. Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses [J]. Ann Surg, 2004; 240(6): 1074-1084.
16.	Nygren J, Soop M, Thorell A, et al. An enhanced-recovery protocol improves outcome after colorectal resection already during the first year: a single-center experience in 168 consecutive patients [J]. Dis Colon Rectum, 2009; 52(5): 978-985.
17.	Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome [J]. Am J Surg, 2002; 183(6): 630-641.
18.	Gatt M, Anderson AD, Reddy BS, et al. Randomized clinical trial of multimodal optimization of surgical care in patients undergoing major colonic resection [J]. Br J Surg, 2005; 92(11): 1354-1362.
19.	Raue W, Haase O, Junghans T, et al. ‘Fast-track’ multimodal rehabilitation program improves outcome after laparoscopic sigmoidectomy: a controlled prospective evaluation [J]. Surg Endosc, 2004; 18(10): 1463-1468.
20.	Bradshaw BG, Liu SS, Thirlby RC. Standardized perioperative care protocols and reduced length of stay after colon surgery [J]. J Am Coll Surg, 1998; 186(5): 501-506.
21.	Fearon KC, Ljungqvist O, Von Meyenfeldt M, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection [J]. Clin Nutr, 2005; 24(3): 466-477.
22.	Kehlet H. Manipulation of the metabolic response in clinical practice [J]. World J Surg, 2000; 24(6): 690-695.

1. Kehlet H. Fast-track colorectal surgery [J]. Lancet， 2008; 371(9615): 791-793.
2. 汪曉東，謝堯，肖軍，等. 快速流程在結直腸外科手術后管理中的應用 [J]. 中國普通外科雜志， 2008； 17（4）： 394-396.
3. Basse L, Thorbl JE, Lssl K, et al. Colonic surgery with accelerated rehabilitation or conventional care[J]. Dis Colon Rectum, 2004; 47(3): 271-277.
4. Delaney CP, Zutshi M, Senagore AJ, et al. Prospective, randomized, controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection [J]. Dis Colon Rectum, 2003; 46(7): 851-859.
5. Anderson AD, McNaught CE, MacFie J, et al. Randomized clinical trial of multimodal optimization and standard perioperative surgical care [J]. Br J Surg, 2003; 90(12): 1497-1504.
6. King PM, Blazeby JM, Ewings P, et al. Randomized clinical trial comparing laparoscopic and open surgery for colorectal cancer within an enhanced recovery programme [J]. Br J Surg, 2006; 93(3): 300-308.
7. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南 [J]. 中國普外基礎與臨床雜志, 2009; 16(5-8): 413, 493-494, 581, 671.
8. Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery [J]. Lancet, 2003; 362(9399): 1921-1928.
9. Maessen JM, Dejong CH, Kessels AG, et al. Length of stay: an inappropriate readout of the success of enhanced recovery programs [J]. World J Surg, 2008; 32(6): 971-975.
10. 肖凌，李蔚，麥玲，等. 快速流程模式下術后限制補液對不同手術方案直腸癌患者康復情況的影響 [J]. 中國普外基礎與臨床雜志， 2010； 17（2）： 190-194.
11. 李立. 結直腸癌外科應用技術的規范與創新（四） [J]. 中國普外基礎與臨床雜志， 2006； 13（4）： 461-468.
12. 周寅，楊廷翰，汪曉東，等. 早期經口進食在結直腸癌術后快速流程模式中的應用 [J]. 中國普外基礎與臨床雜志， 2010； 17(5): 500-503.
13. Hasenberg T, Keese M, Lngle F, et al. ‘Fast-track’ colonic surgery in Austria and Germany-results from the survey on patterns in current perioperative practice [J]. Colorectal Dis, 2009; 11(2): 162-167.
14. Nelson R, Edwards S, Tse B. Prophylactic nasogastric decompression after abdominal surgery[J]. Cochrane Database Syst Rev, 2007; (3): CD004929.
15. Petrowsky H, Demartines N, Rousson V, et al. Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses [J]. Ann Surg, 2004; 240(6): 1074-1084.
16. Nygren J, Soop M, Thorell A, et al. An enhanced-recovery protocol improves outcome after colorectal resection already during the first year: a single-center experience in 168 consecutive patients [J]. Dis Colon Rectum, 2009; 52(5): 978-985.
17. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome [J]. Am J Surg, 2002; 183(6): 630-641.
18. Gatt M, Anderson AD, Reddy BS, et al. Randomized clinical trial of multimodal optimization of surgical care in patients undergoing major colonic resection [J]. Br J Surg, 2005; 92(11): 1354-1362.
19. Raue W, Haase O, Junghans T, et al. ‘Fast-track’ multimodal rehabilitation program improves outcome after laparoscopic sigmoidectomy: a controlled prospective evaluation [J]. Surg Endosc, 2004; 18(10): 1463-1468.
20. Bradshaw BG, Liu SS, Thirlby RC. Standardized perioperative care protocols and reduced length of stay after colon surgery [J]. J Am Coll Surg, 1998; 186(5): 501-506.
21. Fearon KC, Ljungqvist O, Von Meyenfeldt M, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection [J]. Clin Nutr, 2005; 24(3): 466-477.
22. Kehlet H. Manipulation of the metabolic response in clinical practice [J]. World J Surg, 2000; 24(6): 690-695.

《中國普外基礎與臨床雜志》

低位/超低位直腸癌快速流程模式的效果探討

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《中國普外基礎與臨床雜志》

低位/超低位直腸癌快速流程模式的效果探討

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料