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        Fast track surgery in laparoscopy-assisted radical distal gastrectomy

        2012-08-15 00:54:32HuJinchen
        外科研究與新技術(shù) 2012年1期
        關(guān)鍵詞:胡金

        /Hu Jinchen

        (胡金晨,Dept Gen Surg,Qilu Hosp Shandong Univ,Jinan 250012)…∥Chin J Gen Surg.-2011,14(8).-837 ~840

        ObjectiveTo evaluate the safety and effectiveness of fast track surgery(FTS)in laparoscopy-assisted radical distal gastrectomy(LADG)for gastric cancer.MethodsSixty-one patients with distal gastric cancer were randomly divided into three groups:FTS+LADG group(n=19)undergoing LADG and FTS treatments,LADG group(n=22)undergoing LADG and traditional perioperatve cares,and FTS+ODG(open distal gastrectomy)group(n=21)undergoing ODG and FTS treatments.FTS treatments included avoidance of mechanical bowel cleansing,restrictive perioperative intravenous infusion,early ambulation,early enteral nutrition.The age,sex,body weight,anastomtic mode,number of lymph node dissected,and tumor stage,serum albumn(ALB),blood urea nitrogen(BUN),C-reaction protein(CRP),flatus time,postoperative hospital stay,medical cost,and postoperative complications were compared between three groups.ResultsThe level of ALB in FTS+LADG group was higher than in LADG group at the 4th and 7th day after surgery(P < 0.05,P < 0.01).Compared to LADG group,the variation of ALB from preoperation to 4th day after surgery in FTS+LADG group and FTS+ODG group was significant(P < 0.01,P < 0.05).CRP level between FTS+LADG group and FTS+ODG group was different significantly at 4th and 7th day after surgery(P<0.05,P < 0.05).FTS+LADG group has earlier recovery of gastrointestinal peristalsis than other two groups(P <0.05,P <0.05).The medical cost in FTS+LADG group was less than that in LADG group(P=0.003),but higher than in FTS+ODG group(P < 0.01).ConclusionThe practice of FTS in LADG was safe,effective,it improves nutritional status,eases stress reaction,accelerates gastrointestinal perstalsis and postoperative rehabilitaion.6 refs,4 tabs.

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