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| 极速康复外科路径在腹腔镜胃肠肿瘤手术围手术期中的应用 |
| 刘启志1,周慧敏1,周敏君1,陈国忠2,李成2,陈骏毅1,洪永刚3,张楠1,柳汉荣1,涂小煌1* |
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(1. 同济大学附属上海市第四人民医院胃肠外科, 上海200434;
2. 同济大学附属上海市第四人民医院麻醉与围术期医学科, 上海200434;
3. 海军军医大学(第二军医大学)第一附属医院肛肠外科, 上同 济大学附属上
*通信作者) |
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| 摘要: |
| 目的 探讨极速康复外科（FRAS）应用于腹腔镜辅助胃肠肿瘤手术围手术期中的可行性与安全性。方法 收集2023年1月至2024年5月在FRAS和加速康复外科（ERAS）路径下行腹腔镜辅助胃肠肿瘤根治术患者的临床资料，分析围手术期安全性及医疗费用。结果 共纳入87例患者，其中FRAS组43例，ERAS组44例。FRAS组与ERAS组相比，手术时间［3.0（2.5，3.5）h vs 3.0（2.5，4.0）h］、术后首次下床时间［（2.85±4.29）h vs （20.18±6.13）h］、术后首次经口进食时间［2.0（2.0，3.0）h vs 24.0（15.0，48.0）h］、术后住院时间［24.0（20.0，40.0）h vs 192.0（150.0，216.0）h］均缩短，住院费用［50 515.61（46 650.44，56 827.12）元vs 65 555.09（58 683.21，86 239.02）元］和均次药品费用［2 671.09（2 063.31，3 127.09）元vs 7 326.90（5 104.66，10 674.26）元］均降低，差异有统计学意义（均P＜0.05）。结论 在腹腔镜胃肠肿瘤根治术围手术期中采用FRAS路径安全可行，而且能降低住院费用和药品费用。 |
| 关键词: 胃肠肿瘤 腹腔镜手术 根治性切除术 围手术期 极速康复外科 |
| DOI：10.16781/j.CN31-2187/R.20240458 |
| 投稿时间：2024-06-27修订日期：2024-10-09 |
| 基金项目:上海市虹口区科学技术委员会医学课题（虹卫2202-19）;同济大学附属上海市第四人民医院科研启动专项（SYKYQD04401，SYKYQD05101）;同济大学附属上海市第四人民医院学科助推计划（SY-XKZT-2023-2003，SY-XKZT-2023-2001）. |
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| Fastest recovery after surgery during perioperative period under laparoscopic surgery of gastrointestinal tumors |
| LIU Qizhi1,ZHOU Huimin1,ZHOU Minjun1,CHEN Guozhong2,LI Cheng2,CHEN Junyi1,HONG Yonggang3,ZHANG Nan1,LIU Hanrong1,TU Xiaohuang1* |
(1. Department of Gastrointestinal Surgery, Shanghai Fourth People's Hospital Affiliated to Tongji University, Shanghai 200434, China;
2. Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital Affiliated to Tongji University, Shanghai 200434, China;
3. Department of Colorectal Surgery, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To explore the feasibility and safety of fastest recovery after surgery (FRAS) in laparoscopic surgery of gastrointestinal tumors. Methods The clinical data of patients undergoing laparoscopic surgery for gastrointestinal tumors under FRAS and enhanced recovery after surgery (ERAS) from Jan. 2023 to May 2024 were collected, and perioperative safety and medical cost were analyzed. Results A total of 87 patients were enrolled, including 43 in the FRAS group and 44 in the ERAS group. Compared with the ERAS group, the FRAS group had significantly shorter surgical time (3.0 ［2.5, 3.5］ h vs 3.0 ［2.5, 4.0］ h), first postoperative movement time (［2.85±4.29］ h vs ［20.18±6.13］ h), first postoperative oral feeding time (2.0 ［2.0, 3.0］ h vs 24.0 ［15.0, 48.0］ h), postoperative hospital stay (24.0 ［20.0, 40.0］ h vs 192.0 ［150.0, 216.0］ h), lower hospitalization costs (50 515.61 ［46 650.44, 56 827.12］ yuan vs 65 555.09 ［58 683.21, 86 239.02］ yuan), and lower medication costs (2 671.09 ［2 063.31, 3 127.09］ yuan vs 7 326.90 ［5 104.66, 10 674.26］ yuan) (all P＜0.05). Conclusion It is safe and feasible to use FRAS during the perioperative period of laparoscopic radical gastrectomy for gastrointestinal tumors, and FRAS can also reduce the costs of hospitalization and medications. |
| Key words: gastrointestinal neoplasms laparoscopic surgery radical resection perioperative period fastest recovery after surgery |
