Fast Track Surgery in Rib Fracture Fixation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HANZhi-feng ¹ ,  SUYi-jiang ¹ , LIKun-sheng ¹ , ZHAORun-run ¹ , SHENZhen-yun ¹ , HEQi-yue ² , LUGuang-kui ² , HOUGuang-hui ²

1. Department of Thoracic Surgery, BenQ Medical Center, Nanjing Medical University, Nanjing 210019, P. R, China;
2. Department of Anesthesiology, BenQ Medical Center, Nanjing Medical University, Nanjing 210019, P. R, China;

Corresponding author：

SUYi-jiang, Email: toney.su@benqmedicalcenter.com

Keywords：

Fast track surgery; Surgery; Rib fracture; Chest trauma; Surgical stress

DOI：

10.7507/1007-4848.20140007

Video：

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Objective To investigate the feasibility and effectiveness of fast track surgery (FTS) in rib fracture fixation. Methods Fifty-two patients with chest trauma who underwent rib fracture fixation surgery in Mingji Affiliated Hospital of Nanjing Medical University from October 2010 to June 2013 were enrolled in this study. All the patients were divided into FTS group and control group. In the FTS group, there were 26 patients including 22 males and 4 females with their age of 45.62±8.20 years, who received FTS strategies. In the control group, there were 26 patients including 21 males and 5 females with their age of 46.42±7.60 years, who received traditional treatment strategies. Postoperative visual analogue scale (VAS), gastrointestinal function recovery time, postoperative hospital stay and hospitalization cost were compared between the 2 groups. Results VAS at 6 hours, 24 hours and 48 hours postoperatively of FTS group (4.5±0.3, 4.2±0.2, 3.2±0.1) were significantly lower than those of the control group (6.5±0.1, 6.1±0.3, 4.8±0.2) respectively (P < 0.05). Gastrointestinal function recovery time of FTS group (0.8±0.2 days) was significantly shorter than that of the control group (1.5±0.5 days, P < 0.05). Length of hospital stay (21.0±2.6 days) and hospitalization cost (5.18±0.75 ten thousand yuan) of FTS group were significantly shorter or lower than those of the control group (26.2±3.4 days and 5.78±0.64 ten thousand yuan) respectively (P < 0.05). Conclusion FTS strategies can effectively reduce postoperative VAS, shorten length of hospital stay, decrease hospitalization cost, and promote postoperative recovery of rib fracture patients.

Citation： HANZhi-feng, SUYi-jiang, LIKun-sheng, ZHAORun-run, SHENZhen-yun, HEQi-yue, LUGuang-kui, HOUGuang-hui. Fast Track Surgery in Rib Fracture Fixation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(1): 21-24. doi: 10.7507/1007-4848.20140007 Copy

1.	Delaney CP, Fazio VW, Senagore AJ, et al.Fast track.postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery.Br J Surg, 2001, 88 (11):1533-1538.
2.	Wilmore DW, Kehlet H.Recent advances:Management of patients in fast track surgery.BMJ, 2001, 322 (7284):473.
3.	Kehlet H, Wilmore DW.Fast-track surgery.BMJ, 2005, 92 (1):3-4.
4.	黎介寿.对Fast track Surgery (快通道外科)内涵的认识.中华医学杂志, 2007, 87 (8):515.
5.	姜洪池, 孙备, 王刚.快速康复外科的新理念值得重视.中华外科杂志, 2007, 45 (9):577-579.
6.	曾敏, 王旭, 李守军, 等.婴幼儿完全性房室通道矫治术后快速康复.中国胸心血管外科临床杂志, 2010, 17 (6):459-461.
7.	Zhao GB, Cao SQ, Jian C.Fast-track surgery improves postoperative clinicalrecovery and reduces postoperative insulin resistanceafter esophagectomy for esophageal cancer.Support Care Cancer.2013 Sep 26.[Epub ahead of print].
8.	赵光强, 黄云超, 陈小波, 等.快速康复外科在肺癌手术中的应用研究.中国肺癌杂志, 2010, 13 (2):102-106.
9.	郑志水, 黄杰, 林慧庆, 等.快速康复外科理念对开胸肺切除术后应激状态的影响.实用医学杂志, 2012, 28 (18):3095-3098.
10.	Jiang K, Cheng L, Wang JJ, et al.Fast track clinical pathway implications in esophagogastrectomy.World J Gastroenterol, 2009, 15 (4):496-501.
11.	Nutrition LJ.Fast track surgery.J Parenter Enteral Nutr, 2007, 14 (2):65-67.
12.	Søreide E, Eriksson LI, Hirlekar G, et al.Pre-operative fasting guidelines:an update.Acta Anaesthesiol Scand, 2005, 49 (8):1041-1047.
13.	Soop M, Nygren J, Myrenfors P, et al.Preoperative oral carbohydrate treatment attenuates immediate postoperative insulin resistance.Am J Physiol Endocrinol Metab, 2001, 280 (4):576-583.
14.	Lobo DN, Bostock KA, Neal KR, et al.Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection:a randomised controlled trial.Lancet, 2002, 359 (9320):1812-1818.
15.	苏志勇, 张镱镭, 姜天烁, 等.聚左旋乳酸可吸收肋骨钉治疗重症肋骨骨折患者的适应证探讨.中国胸心血管外科临床杂志, 2010, 17 (5):423-424.
16.	陆善伟, 钟竑, 徐怀阳.电视胸腔镜联合形状记忆环抱接骨板治疗多发性肋骨骨折.中国胸心血管外科临床杂志, 2012, 19 (2):210-212.
17.	王洪斌, 张明, 刘海林, 等.微创小切口肋骨内固定术治疗多根多处肋骨骨折及连枷胸.中国胸心血管外科临床杂志, 2012, 19 (4):449-450.
18.	Darido EF, Farrell TM.Fast-track concepts in major open upper abdominal and thoracoabdominal surgery:a review.World J Surg, 2011, 35 (12):2594-2595.
19.	Kehlet H.Fast-track surgery-an update on physiological care principles t enhance recovery.Langenbecks Arch Surg, 2011, 396 (5):585-590.
20.	Ansari D, Gianotti L, Schröder J, et al.Fast-track surgery:procedurespecific aspects and future direction.Langenbecks Arch Surg, 2013, 398 (1):29-37.
21.	Arcaroli J, Silva E, He Q, et al.Third International Symposium on Intensive Care and Emergency Medicine for Latin America.Critical Care, 2005, 9 (2):P1.
22.	Olivier JF, Bracco D, Hemmerling TM, et al.Para-vertebral block versus epidural anesthesia in ultra fast track cardiac surgery.Canadian Journal of Nesthesia/Journal Canadien d'anesthésie, 2007, 54:44530.

1. Delaney CP, Fazio VW, Senagore AJ, et al.Fast track.postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery.Br J Surg, 2001, 88 (11):1533-1538.
2. Wilmore DW, Kehlet H.Recent advances:Management of patients in fast track surgery.BMJ, 2001, 322 (7284):473.
3. Kehlet H, Wilmore DW.Fast-track surgery.BMJ, 2005, 92 (1):3-4.
4. 黎介寿.对Fast track Surgery (快通道外科)内涵的认识.中华医学杂志, 2007, 87 (8):515.
5. 姜洪池, 孙备, 王刚.快速康复外科的新理念值得重视.中华外科杂志, 2007, 45 (9):577-579.
6. 曾敏, 王旭, 李守军, 等.婴幼儿完全性房室通道矫治术后快速康复.中国胸心血管外科临床杂志, 2010, 17 (6):459-461.
7. Zhao GB, Cao SQ, Jian C.Fast-track surgery improves postoperative clinicalrecovery and reduces postoperative insulin resistanceafter esophagectomy for esophageal cancer.Support Care Cancer.2013 Sep 26.[Epub ahead of print].
8. 赵光强, 黄云超, 陈小波, 等.快速康复外科在肺癌手术中的应用研究.中国肺癌杂志, 2010, 13 (2):102-106.
9. 郑志水, 黄杰, 林慧庆, 等.快速康复外科理念对开胸肺切除术后应激状态的影响.实用医学杂志, 2012, 28 (18):3095-3098.
10. Jiang K, Cheng L, Wang JJ, et al.Fast track clinical pathway implications in esophagogastrectomy.World J Gastroenterol, 2009, 15 (4):496-501.
11. Nutrition LJ.Fast track surgery.J Parenter Enteral Nutr, 2007, 14 (2):65-67.
12. Søreide E, Eriksson LI, Hirlekar G, et al.Pre-operative fasting guidelines:an update.Acta Anaesthesiol Scand, 2005, 49 (8):1041-1047.
13. Soop M, Nygren J, Myrenfors P, et al.Preoperative oral carbohydrate treatment attenuates immediate postoperative insulin resistance.Am J Physiol Endocrinol Metab, 2001, 280 (4):576-583.
14. Lobo DN, Bostock KA, Neal KR, et al.Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection:a randomised controlled trial.Lancet, 2002, 359 (9320):1812-1818.
15. 苏志勇, 张镱镭, 姜天烁, 等.聚左旋乳酸可吸收肋骨钉治疗重症肋骨骨折患者的适应证探讨.中国胸心血管外科临床杂志, 2010, 17 (5):423-424.
16. 陆善伟, 钟竑, 徐怀阳.电视胸腔镜联合形状记忆环抱接骨板治疗多发性肋骨骨折.中国胸心血管外科临床杂志, 2012, 19 (2):210-212.
17. 王洪斌, 张明, 刘海林, 等.微创小切口肋骨内固定术治疗多根多处肋骨骨折及连枷胸.中国胸心血管外科临床杂志, 2012, 19 (4):449-450.
18. Darido EF, Farrell TM.Fast-track concepts in major open upper abdominal and thoracoabdominal surgery:a review.World J Surg, 2011, 35 (12):2594-2595.
19. Kehlet H.Fast-track surgery-an update on physiological care principles t enhance recovery.Langenbecks Arch Surg, 2011, 396 (5):585-590.
20. Ansari D, Gianotti L, Schröder J, et al.Fast-track surgery:procedurespecific aspects and future direction.Langenbecks Arch Surg, 2013, 398 (1):29-37.
21. Arcaroli J, Silva E, He Q, et al.Third International Symposium on Intensive Care and Emergency Medicine for Latin America.Critical Care, 2005, 9 (2):P1.
22. Olivier JF, Bracco D, Hemmerling TM, et al.Para-vertebral block versus epidural anesthesia in ultra fast track cardiac surgery.Canadian Journal of Nesthesia/Journal Canadien d'anesthésie, 2007, 54:44530.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Fast Track Surgery in Rib Fracture Fixation

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