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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2011, Vol. 5 Issue (3) : 306-309     DOI: 10.1007/s11684-011-0154-6
RESEARCH ARTICLE |
“Fast Track” nasogastric decompression of rectal cancer surgery
Ka Li1, Zongguang Zhou1,2(), Zengrong Chen1, Yi Zhang2, Cun Wang1,2
1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China; 2. Institute of Digestive Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
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Abstract  

This study evaluates the application of fast track (FT) nasogastric decompression in patients who underwent anterior resection of rectal cancer. A randomized control trial was performed comparing the group with the fast track treatment (n =β57) and the group with traditional nasogastric decompression (n =β84). Preoperative characteristics and postoperative recovery indices were recorded and analyzed. The results indicate no significant differences in gender (P =β0.614), age (P =β0.653), tumor location (P =β0.113), and TNM stages (P =β0.054) were observed between the 2 groups. The differences in the type of resection, anastomosis, and adoption of protective colostomy were all not significant between the FT and the traditional group. During the first 24 hours after surgery, the volume of nasogastric drainage averaged 197 ml in the FT group and 155 ml in the traditional group (P =β0.197). The initiation of test-meal (P =β0.000), semiliquid diet (P =β0.002), and ordinary diet (P =β0.008) were all significantly shorter in the FT group. Furthermore, compared with the other group, the patients in the FT group enjoyed earlier removal of the abdominal drainage, urinary catheter, and shorter hospital stays (P =β0.000). Based on a correlation test, the duration of nasogastric decompression is related to the time of test-meal and semiliquid diet. The routine usage of nasogastric decompression in rectal surgery is unnecessary. The fast track procedure might help in facilitating postoperative functional and diet recovery, reducing the time of catheterization, and shortening hospital stay.

Keywords fast track      nasogastric decompression      rectal cancer      surgery     
Corresponding Authors: Zhou Zongguang,Email:zhou767@163.com   
Issue Date: 05 September 2011
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-011-0154-6     OR     http://academic.hep.com.cn/fmd/EN/Y2011/V5/I3/306
FT groupTraditional groupP value
Gender
Male35480.614
Female2236
Age (year)56.5±13.756.5±11.90.653
Tumor distance from anus (cm)7.4±8.05.7±3.40.113
TNM stage
I8190.054
II2038
III2721
IV26
Abdominal surgical history
No50720.806
Yes712
Existing complications
No44610.691
11018
234
≥301
Surgical procedure
Ultra-low anterior resection31440.815
Anterior resection2640
Colo-anal anastomosis
No46610.271
Yes1123
Protective colostomy
No50730.887
Yes711
Postoperative wards
Surgical ward37430.107
Intensive care unit2041
Tab.1  Clinical and pathological characteristics of included patients
FT groupTraditional groupP value
Nasogastric drainage (ml)a197.6±171.4155.5±142.70.197
Removal of the NGD (day) b1.000±0.0003.1±1.30.000
Time of test meal (day)2.5±1.04.4±2.10.000
Time of semiliquid diet (day)4.1±1.95.8±3.00.002
Time of ordinary diet (day)4.0±0.97.1±4.20.008
Removal of drainage tubes (day)3.3±3.26.5±3.70.000
Removal of urinary catheter (day)4.1±2.26.6±3.50.000
Postoperative hospitalized time (day)9.2±4.612.8±5.60.000
Tab.2  Comparison of recovery indices between the 2 groups
Recovery indicesPearson CorrelationP value
Nasogastric drainage (ml)b0.1050.311
Time of test meal (day)0.5970.000
Time of semiliquid diet (day)0.3900.000
Time of ordinary diet (day)0.3900.066
Removal of drainage tubes (day)0.4250.000
Removal of urinary catheter (day)0.3430.000
Postoperative hospitalized time (day)0.2760.001
Tab.3  Pearson correlation test of recovery indices with the duration of NGD
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