[Reconstructive esophageal surgery in fast track epoch].

Autor:	Shestakov AL; Petrovsky Russian Scientific Center of Surgery, Moscow, Russia., Tarasova IA; Petrovsky Russian Scientific Center of Surgery, Moscow, Russia., Tskhovrebov AT; Petrovsky Russian Scientific Center of Surgery, Moscow, Russia., Boeva IA; Petrovsky Russian Scientific Center of Surgery, Moscow, Russia., Bitarov TT; Petrovsky Russian Scientific Center of Surgery, Moscow, Russia., Bezaltynnykh AA; Petrovsky Russian Scientific Center of Surgery, Moscow, Russia., Shakhbanov ME; Petrovsky Russian Scientific Center of Surgery, Moscow, Russia., Dergunova AP; Petrovsky Russian Scientific Center of Surgery, Moscow, Russia., Vasilyeva ES; Petrovsky Russian Scientific Center of Surgery, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Khirurgiia [Khirurgiia (Mosk)] 2021 (6. Vyp. 2), pp. 73-83.
DOI:	10.17116/hirurgia202106273
Abstrakt:	Objective: To evaluate an efficiency and safety of perioperative fast track management in reconstructive esophageal surgery. Material and Methods: Perioperative fast track management protocol in reconstructive esophageal surgery has been applied since 2014 at the Department of Thoracoabdominal Surgery and Oncology of the Petrovsky Russian Scientific Center of Surgery. These patients (2017-2020) were included in the main group ( n =75). Patients who underwent traditional perioperative care (2010-2013) were enrolled in the control group ( n =63). The primary outcome was postoperative hospital-stay. We also evaluated ICU stay, incidence of complications according to Clavien-Dindo grading system with particular registration of respiratory complications, mortality, enteral and oral feeding onset. Results: There were no significant between-group differences in sex, age, ASA grade, body mass index. Fast track management reduced hospital-stay from 14 (12; 17) days in the control group to 11 (8; 22) days in the main group ( p =0.008). Mean ICU-stay decreased up to 1 (0.8; 2) day in the main group compared to the control group (4.1 (3.5; 5.6) days, p <0.0001). Pneumonia was noted in 5 patients after fast track recovery and 15 patients in the control group ( p =0.004). No patients died in the main group, 3 (4.8%) patients - in the control group ( p =1). Conclusion: Modern perioperative fast track management protocol is safe and effective for extensive reconstructive esophageal interventions. This approach reduces hospital-stay and ICU stay, as well as the incidence of respiratory complications.
Databáze:	MEDLINE
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