加速康复外科联合腹腔镜手术在高龄直肠癌患者中的应用研究  

Application research of enhanced recovery after surgery combined with laparoscopic surgery for aged rectal cancer patients

作　　者：曹金鹏[1] 计勇[1] 杨平[1] 李志澄[1] 朱佳成 张健[1] 朱锦涛 CAO Jin-peng;JI Yong;YANG Ping(Department of Gastrointestinal Surgery,the First People’s Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院胃肠外科,广东佛山528000

出　　处：《腹腔镜外科杂志》2022年第8期584-589,共6页Journal of Laparoscopic Surgery

基　　金：广东省佛山市医学类科技攻关基金项目(2016AB002591)。

摘　　要：目的:探讨加速康复外科联合腹腔镜手术在高龄直肠癌患者中的临床应用价值。方法:回顾总结2010年6月至2021年6月收治的298例70岁以上直肠癌患者的临床资料,其中161例接受加速康复外科联合腹腔镜手术(加速组),137例接受传统康复外科联合腹腔镜手术(传统组),对比分析两组术前一般情况、手术相关指标及术后恢复指标。结果:两组患者术前临床资料、手术方式、手术时间、术中出血量、预防性肠造口比例差异均无统计学意义(P>0.05)。加速组与传统组首次肛门排气时间[(2.3±1.2)d vs.(2.9±1.1)d]、首次进食流质时间[(1.9±1.5)d vs.(3.0±1.6)d]、住院时间[(8.5±5.8)d vs.(10.0±4.5)d]差异有统计学意义(P<0.05);加速组与传统组再次入院率分别为5.0%与2.9%,差异无统计学意义(P>0.05)。两组术后并发症发生率分别为28.6%与32.8%,差异亦无统计学意义(P>0.05)。加速组中患者加速项目总依从率为89%。结论:加速康复外科联合腹腔镜手术治疗高龄直肠癌患者是安全、可行的,可缩短术后恢复时间、住院时间,不增加术后并发症发生率与再次入院率。Objective:To observe the clinical application value of enhanced recovery after surgery(ERAS)combined with l aparoscopic surgery in elderly rectal cancer patients.Methods:A retrospective analysis was conducted among 298 rectal cancer p atients who were over 70 years old from Jun.2010 to Jun.2021.161 patients who underwent ERAS combined with laparoscopic operation(ERAS group)were compared with 137 patients who underwent laparoscopic surgery with traditional protocol(conventional group).The two groups were compared in terms of preoperative clinical data,details of operations and postoperative recovery.Results:There were no significant differences between the two groups in terms of preoperative clinical data,operation type,operative time,blood loss,preventive ileostomy/colostomy(P>0.05).Between the ERAS group and conventional group,the average time of first flatus,first time to liquid diet,hospital stay were[(2.3±1.2)d vs.(2.9±1.1)d],[(1.9±1.5)d vs.(3.0±1.6)d],[(8.5±5.8)d vs.(10.0±4.5)d]respectively,which were significantly different(P<0.05).There was no difference in readmission rate(5.0%vs.2.9%,P>0.05)and postoperative complication incidence(28.6%vs.32.8%,P>0.05)between the two groups.Overall percentage of c ompliance with the ERAS protocol was 89%.Conclusions:The introduction of the ERAS protocol for laparoscopic operation in elderly rectal cancer patients can be performed safely and feasibly,it can reduce postoperative recovery duration,hospital stay without increasing the postoperative complication incidence or readmission rate compared with traditional protocol.

关 键 词：直肠肿瘤 腹腔镜检查 加速康复外科 老年人 

分 类 号：R735.37[医药卫生—肿瘤]