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

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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):515-517.
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, Thorbøl JE, Løssl 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.	中华医学会肠外肠内营养学分会加速康复外科协作组.结直肠手术应用加速康复外科中国专家共识(2015版).中华胃肠外科杂志, 2015, 18(8):785-787.
12.	刘展, 汪晓东, 李立.多学科协作诊治模式下的结直肠外科快速康复流程.中国普外基础与临床杂志, 2007, 14(2):239-242.
13.	李立, 汪晓东, 舒晔, 等.四川大学华西医院肛肠外科·结直肠外科快速流程临床指南(一).中国普外基础与临床杂志, 2009, 16(5):413.
14.	李立, 汪晓东, 舒晔, 等.四川大学华西医院肛肠外科·结直肠外科快速流程临床指南(二).中国普外基础与临床杂志, 2009, 16(6):493-494.
15.	李立, 汪晓东, 舒晔, 等.四川大学华西医院肛肠外科·结直肠外科快速流程临床指南(三).中国普外基础与临床杂志, 2009, 16(7):581.
16.	李立, 汪晓东, 舒晔, 等.四川大学华西医院肛肠外科·结直肠外科快速流程临床指南(四).中国普外基础与临床杂志, 2009, 16(8):671.
17.	杨廷翰, 蒲怡, 杨光超, 等.快速流程完成率对结直肠癌根治术术后管理的影响.中国普外基础与临床杂志, 2010, 17(11):1203-1206.
18.	刘展, 汪晓东, 李立.结直肠外科快速流程内容及依据.中国普外基础与临床杂志, 2007, 14(4):469-473.
19.	Basse L, Hjort Jakobsen D, Billesbølle 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.	复旦大学附属中山医院围手术期处理多学科团队; 秦新裕, 刘凤林.普外科病人围手术期血栓预防——中山共识(2).中国实用外科杂志, 2013, 33(11):946-948.
22.	关振鹏, 吕厚山.外科相关静脉血栓栓塞的防治.中国临床医生, 2009, 37(9):5-8.
23.	刘晨宇, 赵玉洲, 梁玉芝, 等.低分子量肝素预防直肠癌术后深静脉血栓形成的效果观察.中国综合临床, 2015, 31(7):641-643.
24.	张国忠, 杨琛腾.静脉血栓栓塞症相关危险因素研究进展.河北医科大学学报, 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.	程黎阳.快速康复外科的现状分析与前景展望.实用医学杂志, 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):515-517.
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, Thorbøl JE, Løssl 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. 中华医学会肠外肠内营养学分会加速康复外科协作组.结直肠手术应用加速康复外科中国专家共识(2015版).中华胃肠外科杂志, 2015, 18(8):785-787.
12. 刘展, 汪晓东, 李立.多学科协作诊治模式下的结直肠外科快速康复流程.中国普外基础与临床杂志, 2007, 14(2):239-242.
13. 李立, 汪晓东, 舒晔, 等.四川大学华西医院肛肠外科·结直肠外科快速流程临床指南(一).中国普外基础与临床杂志, 2009, 16(5):413.
14. 李立, 汪晓东, 舒晔, 等.四川大学华西医院肛肠外科·结直肠外科快速流程临床指南(二).中国普外基础与临床杂志, 2009, 16(6):493-494.
15. 李立, 汪晓东, 舒晔, 等.四川大学华西医院肛肠外科·结直肠外科快速流程临床指南(三).中国普外基础与临床杂志, 2009, 16(7):581.
16. 李立, 汪晓东, 舒晔, 等.四川大学华西医院肛肠外科·结直肠外科快速流程临床指南(四).中国普外基础与临床杂志, 2009, 16(8):671.
17. 杨廷翰, 蒲怡, 杨光超, 等.快速流程完成率对结直肠癌根治术术后管理的影响.中国普外基础与临床杂志, 2010, 17(11):1203-1206.
18. 刘展, 汪晓东, 李立.结直肠外科快速流程内容及依据.中国普外基础与临床杂志, 2007, 14(4):469-473.
19. Basse L, Hjort Jakobsen D, Billesbølle 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. 复旦大学附属中山医院围手术期处理多学科团队; 秦新裕, 刘凤林.普外科病人围手术期血栓预防——中山共识(2).中国实用外科杂志, 2013, 33(11):946-948.
22. 关振鹏, 吕厚山.外科相关静脉血栓栓塞的防治.中国临床医生, 2009, 37(9):5-8.
23. 刘晨宇, 赵玉洲, 梁玉芝, 等.低分子量肝素预防直肠癌术后深静脉血栓形成的效果观察.中国综合临床, 2015, 31(7):641-643.
24. 张国忠, 杨琛腾.静脉血栓栓塞症相关危险因素研究进展.河北医科大学学报, 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. 程黎阳.快速康复外科的现状分析与前景展望.实用医学杂志, 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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