Application of fast-track surgery in the management of nutritional risk on patients with esophageal carcinoma after esophagectomy perioperatively / 中华临床营养杂志

ABSTRACT

Objective To evaluate the influence of fast-track surgery in perioperative period on the clinical outcomes of patients at nutritional risk in respectable esophageal cancer surgery perioperatively.Methods A total of 170 esophageal carcinoma patients receiving radical operation in our hospital from January 2008 to December 2013 were randomly divided into two groups by simple random method (n =85 each)one group was treated with the new concept of FTS-based on nutritional risk screening (FTS group),and the other control group received conventional perioperative management (CPM group).The postoperative first passage of flatus and defecation,time to drainage tube removal,postoperative hospital stay,and morbidity of the postoperative complication were recorded and compared.Results The time to drainage tube removal and length of postoperative hospital stay were significantly lower in the FTS group than those in the CPM group,and the overall postoperative complication rate was 7.06％ (6/85) in the FTS group and 20.00％ (17/85) in the CPM group (all P ＜0.05).In FTS group,the first flatus time was (59.01 ±2.73) h,the first defecation time was (3.35 ± 1.37) d,removing time of chest tube was (2.76 ±0.34) d,and postoperative hospital days was (8.16 ± 0.80) d; in the control group,they were (90.16 ±2.82) h,(4.78 ± 1.74) d,(4.39 ±0.25) d,and (10.93 ± 1.39) d respectively,showing significant differences (all P ＜0.05).The operative time was similar between these two groups.Conclusion The new concept of FTS by nutrition risk screening and intervention apparently can accelerate recovery after esophagngastrectomy,reduce the rate of overall complications,promote bowel function recovery,and decrease morbidity in the perioperative period for patients with esophageal carcinoma.