Application Actuality of Fast Track for Colorectal Surgery in China_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIUZhan ¹ ,  LIYun-tao ¹ , JIANGHua ² , PANGYu ³ , CHENGNing ³ , LIUYan-jun ¹ , FENGJin-yan ¹ , LUODan ¹ , LIShi-hong ¹ , GUJian-hui ¹

1. Department of General Surgery, The Third People's Hospital of Chengdu, Chengdu 610031, Sichuan Province, China;
2. Department of Anesthesiology, The Third People's Hospital of Chengdu, Chengdu 610031, Sichuan Province, China;
3. Department of Hospital Information Management, The Third People's Hospital of Chengdu, Chengdu 610031, Sichuan Province, China;

Corresponding?author：

LIYun-tao, Email: yuntaodrli@qq.com

Keywords：

Fast track; Colorectal surgery; Actuality

DOI：

10.7507/1007-9424.20160274

Video：

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Objective To summary and analyze the actuality of application for the fast track (FT) in China. Methods The clinical literatures of FT in China were collected and obtained from the WanFang database and China Hospital Knowledge Database (from Jan. 2006 to Dec. 2014), and then the actuality of application for the 22 items of FT was analyzed. Results A total of 62 literatures were collected, and there were 58 hospitals and 2 944 cases who underwent colorectal operation included. In all of the 62 literatures, the programmes were carried out 15 items at most, and there were only 3 items (average 10.06 items) at least. There were some important FT programmes were poorly developed (less than 60.00%) which included:normal preoperative feeding (45.16%, 28/62), intake carbohydrate drinks up until 2 hours before operation (54.84%, 34/62), thoracic epidural analgesia (58.06%, 36/62), avoid the opioids (35.48%, 22/62), minimally invasive operation (58.06%, 36/62), no nasogastric intubation (53.22%, 33/62), establish discharge criteria (27.42%, 17/62), follow-up (14.52%, 9/62), and audit of clinical outcomes (1.61%, 1/62). And that, there were serious distortions to some FT programmes, such as:distorted the surgery with epidural anesthesia to the thoracic epidural analgesia (46.77%, 29/62), distorted the early remove nasogastric intubation postoperative to avoidance the nasogastric intubation (17.74%, 11/62), and the minimally invasive surgery was independent of FT (6.45%, 4/62)/control the fluid therapy intraoperatively only (6.45%, 4/62). Conclusion The current situation of the FT is not optimistic in China, it has existed that the concept of FT is fuzziness, the measures are not standardized and the application of some important programmes are deficient.

Citation： LIU Zhan, LI Yun-tao, JIANG Hua, PANG Yu, CHENG Ning, LIU Yan-jun, FENG Jin-yan, LUO Dan, LI Shi-hong, GU Jian-hui. Application Actuality of Fast Track for Colorectal Surgery in China. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(9): 1061-1065. doi: 10.7507/1007-9424.20160274 Copy

1.	Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284):473-476.
2.	黎介壽.對Fast-track Surgery (快通道外科)內涵的認識.中華醫學雜志, 2007, 87(8):515-517.
3.	Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg, 2006, 30(8):1382-1391.
4.	Basse L, Thorb?l JE, L?ssl K, et al. Colonic surgery with accelerated rehabilitation or conventional care. Dis Colon Rectum, 2004, 47(3):271-278.
5.	Wind J, Polle SW, Fung Kon Jin PH, et al. Systematic review of enhanced recovery programmes in colonic surgery. Br J Surg, 2006, 93(7):800-809.
6.	Hjort Jakobsen D, Sonne E, Basse L, et al. Convalescence after colonic resection with fast-track versus conventional care. Scand J Surg, 2004, 93(1):24-28.
7.	Fearon KC, Ljungqvist O, Von Meyenfeldt M, et al. Enhanced recovery after surgery:a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr, 2005, 24(3):466-477.
8.	Feroci F, Lenzi E, Baraghini M, et al. Fast-track surgery in real life:how patient factors influence outcomes and compliance with an enhanced recovery clinical pathway after colorectal surgery. Surg Laparosc Endosc Percutan Tech, 2013, 23(3):259-265.
9.	Chestovich PJ, Lin AY, Yoo J. Fast-track pathways in colorectal surgery. Surg Clin North Am, 2013, 93(1):21-32.
10.	Sehgal R, Hill A, Deasy J, et al. Fast-track for the modern colorectal department. World J Surg, 2012, 36(10):2473-2480.
11.	中華醫學會腸外腸內營養學分會加速康復外科協作組.結直腸手術應用加速康復外科中國專家共識(2015版).中華胃腸外科雜志, 2015, 18(8):785-787.
12.	劉展, 汪曉東, 李立.多學科協作診治模式下的結直腸外科快速康復流程.中國普外基礎與臨床雜志, 2007, 14(2):239-242.
13.	李立, 汪曉東, 舒曄, 等.四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(一).中國普外基礎與臨床雜志, 2009, 16(5):413.
14.	李立, 汪曉東, 舒曄, 等.四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(二).中國普外基礎與臨床雜志, 2009, 16(6):493-494.
15.	李立, 汪曉東, 舒曄, 等.四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(三).中國普外基礎與臨床雜志, 2009, 16(7):581.
16.	李立, 汪曉東, 舒曄, 等.四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(四).中國普外基礎與臨床雜志, 2009, 16(8):671.
17.	楊廷翰, 蒲怡, 楊光超, 等.快速流程完成率對結直腸癌根治術術后管理的影響.中國普外基礎與臨床雜志, 2010, 17(11):1203-1206.
18.	劉展, 汪曉東, 李立.結直腸外科快速流程內容及依據.中國普外基礎與臨床雜志, 2007, 14(4):469-473.
19.	Basse L, Hjort Jakobsen D, Billesb?lle P, et al. A clinical pathway to accelerate recovery after colonic resection. Ann Surg, 2000, 232(1):51-57.
20.	Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6):630-641.
21.	復旦大學附屬中山醫院圍手術期處理多學科團隊; 秦新裕, 劉鳳林.普外科病人圍手術期血栓預防——中山共識(2).中國實用外科雜志, 2013, 33(11):946-948.
22.	關振鵬, 呂厚山.外科相關靜脈血栓栓塞的防治.中國臨床醫生, 2009, 37(9):5-8.
23.	劉晨宇, 趙玉洲, 梁玉芝, 等.低分子量肝素預防直腸癌術后深靜脈血栓形成的效果觀察.中國綜合臨床, 2015, 31(7):641-643.
24.	張國忠, 楊琛騰.靜脈血栓栓塞癥相關危險因素研究進展.河北醫科大學學報, 2015, 36(7):858-862.
25.	Clagett GP, Anderson FJ Jr, Geerts W, et al. Prevention of venous thromboembolism. Chest, 1998, 114(5 Suppl):531S-560S.
26.	程黎陽.快速康復外科的現狀分析與前景展望.實用醫學雜志, 2012, 28(1):1-4.

1. Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284):473-476.
2. 黎介壽.對Fast-track Surgery (快通道外科)內涵的認識.中華醫學雜志, 2007, 87(8):515-517.
3. Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg, 2006, 30(8):1382-1391.
4. Basse L, Thorb?l JE, L?ssl K, et al. Colonic surgery with accelerated rehabilitation or conventional care. Dis Colon Rectum, 2004, 47(3):271-278.
5. Wind J, Polle SW, Fung Kon Jin PH, et al. Systematic review of enhanced recovery programmes in colonic surgery. Br J Surg, 2006, 93(7):800-809.
6. Hjort Jakobsen D, Sonne E, Basse L, et al. Convalescence after colonic resection with fast-track versus conventional care. Scand J Surg, 2004, 93(1):24-28.
7. Fearon KC, Ljungqvist O, Von Meyenfeldt M, et al. Enhanced recovery after surgery:a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr, 2005, 24(3):466-477.
8. Feroci F, Lenzi E, Baraghini M, et al. Fast-track surgery in real life:how patient factors influence outcomes and compliance with an enhanced recovery clinical pathway after colorectal surgery. Surg Laparosc Endosc Percutan Tech, 2013, 23(3):259-265.
9. Chestovich PJ, Lin AY, Yoo J. Fast-track pathways in colorectal surgery. Surg Clin North Am, 2013, 93(1):21-32.
10. Sehgal R, Hill A, Deasy J, et al. Fast-track for the modern colorectal department. World J Surg, 2012, 36(10):2473-2480.
11. 中華醫學會腸外腸內營養學分會加速康復外科協作組.結直腸手術應用加速康復外科中國專家共識(2015版).中華胃腸外科雜志, 2015, 18(8):785-787.
12. 劉展, 汪曉東, 李立.多學科協作診治模式下的結直腸外科快速康復流程.中國普外基礎與臨床雜志, 2007, 14(2):239-242.
13. 李立, 汪曉東, 舒曄, 等.四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(一).中國普外基礎與臨床雜志, 2009, 16(5):413.
14. 李立, 汪曉東, 舒曄, 等.四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(二).中國普外基礎與臨床雜志, 2009, 16(6):493-494.
15. 李立, 汪曉東, 舒曄, 等.四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(三).中國普外基礎與臨床雜志, 2009, 16(7):581.
16. 李立, 汪曉東, 舒曄, 等.四川大學華西醫院肛腸外科·結直腸外科快速流程臨床指南(四).中國普外基礎與臨床雜志, 2009, 16(8):671.
17. 楊廷翰, 蒲怡, 楊光超, 等.快速流程完成率對結直腸癌根治術術后管理的影響.中國普外基礎與臨床雜志, 2010, 17(11):1203-1206.
18. 劉展, 汪曉東, 李立.結直腸外科快速流程內容及依據.中國普外基礎與臨床雜志, 2007, 14(4):469-473.
19. Basse L, Hjort Jakobsen D, Billesb?lle P, et al. A clinical pathway to accelerate recovery after colonic resection. Ann Surg, 2000, 232(1):51-57.
20. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6):630-641.
21. 復旦大學附屬中山醫院圍手術期處理多學科團隊; 秦新裕, 劉鳳林.普外科病人圍手術期血栓預防——中山共識(2).中國實用外科雜志, 2013, 33(11):946-948.
22. 關振鵬, 呂厚山.外科相關靜脈血栓栓塞的防治.中國臨床醫生, 2009, 37(9):5-8.
23. 劉晨宇, 趙玉洲, 梁玉芝, 等.低分子量肝素預防直腸癌術后深靜脈血栓形成的效果觀察.中國綜合臨床, 2015, 31(7):641-643.
24. 張國忠, 楊琛騰.靜脈血栓栓塞癥相關危險因素研究進展.河北醫科大學學報, 2015, 36(7):858-862.
25. Clagett GP, Anderson FJ Jr, Geerts W, et al. Prevention of venous thromboembolism. Chest, 1998, 114(5 Suppl):531S-560S.
26. 程黎陽.快速康復外科的現狀分析與前景展望.實用醫學雜志, 2012, 28(1):1-4.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application Actuality of Fast Track for Colorectal Surgery in China

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