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2011 | 83 | 9 | 482-487
Tytuł artykułu

Implementation of the Fast Track Surgery in Patients Undergoing the Colonic Resection - Own Experience

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
A perioperative care in the colorectal surgery has been considerably changed recently. The fast track surgery decreases complications rate, shortens length of stay, improves quality of life and leads to cost reduction. It is achieved by: resignation of a mechanical bowel preparation before and a nasogastric tube insertion after operation, optimal pain and intravenous fluid management, an early rehabilitation, enteral nutrition and removal of a vesical catheter and abdominal drain if used.The aim of the study was to compare the results of an implementation the fast track surgery protocol with results achieving in the conventional care regimen.Material and methods. Two groups of patients undergoing colonic resection have been compared. The study group was formed by patients treated with fast track concept, the control group - by patients who were dealt with hitherto regimen. Procedures needed stoma performing, rectal and laparoscopic surgery were excluded. The perioperative period was investigated by telephone call to patient or his family.Results. Statistical significant reduction was reached in a favour of the fast track group in the following parameters: the length of hospital stay (2.5 days shorter), duration of an abdominal cavity and vesicle drainage (3 and 2 days shorter respectively), postoperative day on which oral diet was implemented (2,5 days faster) and finally extended (1.5 days faster). There were no statistical difference in mortality, morbidity neither reoperation rate between two groups.Conclusion. The fast track surgery is a safe strategy and may improve a perioperative care.
Słowa kluczowe
Wydawca

Rocznik
Tom
83
Numer
9
Strony
482-487
Opis fizyczny
Daty
wydano
2011-09-01
online
2011-10-05
Twórcy
  • Department of General, Gastroenterological and Oncological Surgery of the Central Public Clinical, Hospital Warsaw Medical University
  • Department of General, Gastroenterological and Oncological Surgery of the Central Public Clinical, Hospital Warsaw Medical University
Bibliografia
  • Morończyk DAF, Krasnodębski IW: Fast track surgery (szybka ścieżka chirurgiczna) ze szczególnym uwzględnieniem chorych poddanych zabiegom resekcyjnym jelita grubego. Pol Przegl Chir 2011 1: 92-104.
  • Andersen J, Hjort-Jakobsen, Christiansen PS et al.: Readmission rates arter a planned hospital stay of 2 versus 3 days in fast-track colonic surgery. Br J Surg 2007; 94: 890-93.
  • Kehlet H, Wilmore DW: Evidence-Based Surgical Care and the Evolution of Fast - track surgery. Ann Surg 2008; 248: 189-98.
  • Nygren J, Thorell A, Ljungqvist O: Preoperative oral carbohydrate nutrition: an update. Curr Op Clin Nutr Metab Care 2001; 4: 255-59.[Crossref]
  • Ljungqvist O, Nygren J, Thorell A: Modulation of post-operative insulin resistance by pre-operative carbohydrate loading. Proc Nutr Soc 2002; 61: 329-35.
  • Mathur S, Plank LD, McCall JL et al.: Randomised controlled trial of preoperative oral carbohydrate treatment in major abdominal surgery. Br J Surg 2010; 97: 485-94.
  • Brady MC, Kinn S, Stuart P, Ness V: Preoperative fasting for adults to prevent perioperative complications. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD004423.[WoS]
  • Slim K, Vicaut E, Launay-Savary MV et al.: Updated systematic review and metaanalysis of randomized clinical trials on the role of mechanical bowel preperation before colorectal surgery. Ann Surg 2009; 249: 203-309.[WoS]
  • Guenaga KKFG, Matos D, Wille-Jørgensen P: Mechanical bowel preparation for elective colorectal surgery. CochraneDatabase of Systematic Reviews 2009, Issue 1. Art. No.: CD001544.
  • Verma R, Nelson RL: Prophylactic nasogastric decompression after abdominal surgery. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD004929.[WoS]
  • Jesus EC, Karliczek A, Matos D et al.: Prophylactic anastomotic drainage for colorectal surgery. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD 002100.
  • Petrowsky H, Demartines N, Rousson V et al.: Evidence-based value of prophylactic drainage in gastointestinal surgery. A systematic review and meta-analysis. Ann Surg 2004; 240: 1074-85.
  • Andersen H, Lewis S, Thomas S: Early enteral nutrition within 24h of colorectal surgery versus commencement of feeding for postoperative complications. Cochrane Database of Systematic Reviews 2006 Issue 4. No.: CD 004080.
  • Rahbari N, Zimmermann J, Schmidt T et al.: Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery. Br J Surg 2009; 96: 331-41.[WoS]
  • Marret E, Remy C, Bonnet F: Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery British Journal of Surgery 2007; 94: 665-73.[WoS][Crossref]
  • Wu CL, Cohen SR, Richman JM: Efficacy of Postoperative Patient-controlled and Continuous Infusion Epidural Analgesia versus Intravenous Patient-controlled Analgesia with Opioids. Anesthesiology 2005; 103:1079-88.
  • Liu SS, Richman J, Thirlby RC et al.: Efficacy of Continuous Wound Catheters Delivering Local Anesthetic for Postoperative Analgesia: A Quantitative and Qualitative Systematic Review of Randomized Controlled Trials. J Am Coll Surg 2006; 203: 914-32.
  • Pascal HE, Teeuwen RP, Bleichrodt C: Strik et al. Enhanced Recovery After Surgery (ERAS) Versus Conventional Postoperative Care in Colorectal Surgery. J Gastrointest Surg 2010; 14:88-95.
  • Ionescu D, Iancu C, Ion D et al.: Implementing Fast-Track Protocol for Colorectal Surgery: A Prospective Randomized Clinical Trial. World J Surg 2009; 33: 2433-38.[WoS][Crossref]
  • Wang G, Jiang ZW, Xu J et al.: Fast-track rehabilitation program vs conventional care after colorectal resection: A randomized clinical trial. World J Gastroenterol 2011; 17(5): 671-76.[WoS][Crossref]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_v10035-011-0075-8
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