Application of fast track surgery strategy in retroperitoneal laparoscopic adrenalectomy
- VernacularTitle:加速康复外科在后腹腔镜肾上腺切除术中的应用
- Author:
Chaopeng TANG
;
Zhenyu XU
;
Jianping GAO
;
Zhengyu ZHANG
;
Xiaoming YI
;
Jie DONG
;
Zhifeng WEI
;
Feng XU
;
Wenquan ZHOU
- Publication Type:Journal Article
- Keywords:
Fast tract surgery;
Retroperitoneal laparoscopic adrenalectomy;
Perioperative period;
Visual analogue scale
- From:
Journal of Medical Postgraduates
2014;(8):829-832
- CountryChina
- Language:Chinese
-
Abstract:
Objective Studies on the application of fast track surgery ( FTS) are comparatively limited in urologic proce-dures.This randomized controlled study was to evaluate the impact of FTS on recovery after retroperitoneal laparoscopic adrenalectomy . Methods Eighty patients undergoing retroperitoneal laparoscopic adrenalectomy were randomly assigned to an FTS and a control group of equal number to receive an FTS recovery program and conventional perioperative care , respectively .Comparisons were made between the two groups in the time of the first flatus , first oral nutrition , and first mobilization , the incidence of gastrointestinal tract complica-tions, the time of drainage and transurethral catheterization , the length of postoperative hospital stay , hospitalization expenses , visual analogue scale (VAS) pain scores, and general state of the patients . Results The FTS group, in comparison with the control, showed significantly earlier time of first flatus ([20.6 ±8.3] vs [39.8 ±18.3]h, P<0.05), first oral nutrition ([21.1 ±9.9] vs [51.8 ±16.9]h, P<0.05), and first mobilization ([23.6 ±9.0] vs [55.6 ±18.5]h, P<0.05), markedly shorter time of drain-age ([20.9 ±7.9] vs [70.6 ±18.9]h, P<0.05), transurethral catheterization ([20.2 ±8.3] vs[62.5 ±27.1]h, P<0.05), and postoperative hospital stay ([2.43 ±0.94] vs [5.46 ±1.60] d, P<0.05), remarkably less expenses of hospitalization ([21.7 ± 3.2] vs [28.6 ±6.5] ￥1000, P<0.05), and lower postoperative pain scores at 12 h (0.93 ±0.89 vs 1.80 ±1.38), at 24 h while coughing (1.27 ±0.99 vs 4.65 ±1.33), and at 24 h at rest (0.70 ±0.61 vs 1.40 ±0.84) (P<0.05).The general state score was dramatically higher in the FTS patients than in the control on postoperative day (POD) 1 (6.85 ±1.00 vs 4.28 ±1.11) and POD 2 (8.30 ±0.94 vs 5.53 ±1.24) (P<0.01).No significant differ-ences were observed in the general state of the patients between POD 2 and the baseline (P>0.05), nor in the incidence of gastrointesti-nal tract complications between the FTS and control groups ( P >0.05). Conclusion By improving the general state and accelera-ting the recovery of the patients , FTS can be applied safely and effectively in retroperitoneal laparoscopic adrenalectomy .
