Application Study Of Fast Track Surgery On Retcal Cancer Anus Saving Patients

Background and Aim: Colorectal cancer is one of the most common and deadly diseases these days, and its morbidity is going up year after year. Surgery is the main method to treat the deadly disease. The traditional method of Miles plays an important role in the treatment. The method of retcal cancer anus saving procedure can improve the life quality of patients and is appealed by patients, but it also has some drawbacks such as long stay in hospital and less efficient of bed use. Bed utilization rates, turnover is the comprehensive evaluation indices such as section efficiency and benefit, medical quality and technology level of comparative rigid comprehensive indicator Fast track surgery (FTS), a new technology developed in the last years, has been reported to accelerate the recovery of patients ,shorten days in hospital, decrease the expenses. Objectives (1) To explore a scale to put fast track surgery into practice which would be suited for the situation of our clinical practice. (2) To investigate the usefulness and effectiveness of using fast track surgery Index system in perioperative period of colorectal cancer patient.(3) To compare the advantage values of hospital beds before and after using fast track surgery in clinic. Methods (1) To construct the index system: The Delphi method was used through recruiting 25 experts in the area of general surgery, anesthesiology and clinical nursing. The contents of the scale were identified in the light of experts'common suggestions after a two-round meeting. (2)Application of index system: 110 retcal cancer anus saving procedure patients in 2008 using fast track surgery in perioperative period as trial group, and 80 patients using traditional protocol in 2007 as control group were compared in the index of postoperative bowel venting, hospital stay time, medical treatment cost and complication. The serum level changes of CRP and IL-6 were also examined. (3) Using normalization analysis to compare the efficency values of hospital beds in 2008 which retcal cancer patients were treated by fast track surgery with patients in 2007 . Results After the two-round meeting, the overall authority grade was 0. 854 and 0.855 with the respond rates of 92% and 95. 6% respectively. The scale was set up based on the experts'advices which including 7 factors and 28 items. (2) Compared to the placebo group, the fast track surgery group could accelerate recovery of bowel function, decrease hospital stay time, and medical treatment cost, Serum concentration of CRP and IL-6 in FTS group were lower than in the placebo group(P <0.05) .No significant difference was observed between the two groups of complication rate (P>0.05).(3) Efficiency values of hospital beds in 2008 significantly increased compared with that of 2007.Conclusion (1) The study of FTS on retcal cancer anus saving patients has great value in practical applications (2) The use of FTS could accelerate recovery of bowel function, decrease hospital stay time, decreas medical treatment cost as well as serum concentration of CRP and IL-6.(3) Efficiency values of hospital beds were improved significantly after the FTS treatment.