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.	黎介壽.對Fast track Surgery (快通道外科)內涵的認識.中華醫學雜志, 2007, 87 (8):515.
5.	姜洪池, 孫備, 王剛.快速康復外科的新理念值得重視.中華外科雜志, 2007, 45 (9):577-579.
6.	曾敏, 王旭, 李守軍, 等.嬰幼兒完全性房室通道矯治術后快速康復.中國胸心血管外科臨床雜志, 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.	趙光強, 黃云超, 陳小波, 等.快速康復外科在肺癌手術中的應用研究.中國肺癌雜志, 2010, 13 (2):102-106.
9.	鄭志水, 黃杰, 林慧慶, 等.快速康復外科理念對開胸肺切除術后應激狀態的影響.實用醫學雜志, 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.	S?reide 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.	蘇志勇, 張鐿鐳, 姜天爍, 等.聚左旋乳酸可吸收肋骨釘治療重癥肋骨骨折患者的適應證探討.中國胸心血管外科臨床雜志, 2010, 17 (5):423-424.
16.	陸善偉, 鐘竑, 徐懷陽.電視胸腔鏡聯合形狀記憶環抱接骨板治療多發性肋骨骨折.中國胸心血管外科臨床雜志, 2012, 19 (2):210-212.
17.	王洪斌, 張明, 劉海林, 等.微創小切口肋骨內固定術治療多根多處肋骨骨折及連枷胸.中國胸心血管外科臨床雜志, 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, Schr?der 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. 黎介壽.對Fast track Surgery (快通道外科)內涵的認識.中華醫學雜志, 2007, 87 (8):515.
5. 姜洪池, 孫備, 王剛.快速康復外科的新理念值得重視.中華外科雜志, 2007, 45 (9):577-579.
6. 曾敏, 王旭, 李守軍, 等.嬰幼兒完全性房室通道矯治術后快速康復.中國胸心血管外科臨床雜志, 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. 趙光強, 黃云超, 陳小波, 等.快速康復外科在肺癌手術中的應用研究.中國肺癌雜志, 2010, 13 (2):102-106.
9. 鄭志水, 黃杰, 林慧慶, 等.快速康復外科理念對開胸肺切除術后應激狀態的影響.實用醫學雜志, 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. S?reide 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. 蘇志勇, 張鐿鐳, 姜天爍, 等.聚左旋乳酸可吸收肋骨釘治療重癥肋骨骨折患者的適應證探討.中國胸心血管外科臨床雜志, 2010, 17 (5):423-424.
16. 陸善偉, 鐘竑, 徐懷陽.電視胸腔鏡聯合形狀記憶環抱接骨板治療多發性肋骨骨折.中國胸心血管外科臨床雜志, 2012, 19 (2):210-212.
17. 王洪斌, 張明, 劉海林, 等.微創小切口肋骨內固定術治療多根多處肋骨骨折及連枷胸.中國胸心血管外科臨床雜志, 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, Schr?der 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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