Effects of multimodal fast-track surgery on liver transplantation outcomes

查看全文 作　　者：Jian-Hua [1,2]Rao;Feng [1,2]Zhang;Hao [1,2]Lu;Xin-Zheng [1,2]Dai;Chuan-Yong [1,2]Zhang;Xiao-Feng [1,2]Qian;Xue-Hao [1,2]Wang;Ling [1,2]Lu

机构地区：[1]Liver Transplantation Center,First Affiliated Hospital of Nanjing Medical University;[2]Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health,Nanjing 210029,China

出　　处：《Hepatobiliary & Pancreatic Diseases International》索引2017年第16卷第4期,共6页

基　　金：supported by grants from the Foundation of Jiangsu Collaborative Innovation Center of Biomedical Functional Materials,Basic Research Program-Youth Fund Project of Jiangsu Province(BK20140092);the National Natural Science Foundation of China(81400650,81470901,81273261 and 81270583) 摘　　要：BACKGROUND:Fast-track surgery and enhanced recovery after surgery have been applied to many surgical procedures;however,data on fast-track surgery and enhanced recovery after surgery following liver transplantation is limited.This study aimed to conduct a prospective study to determine the effects of fast-track surgery on prognosis after liver transplantation.METHODS:This was a prospective,single-blinded,randomized study.One hundred twenty-eight patients undergoing liver transplantation were selected for the fast-track(FT group,n=54) or conventional process(NFT group,n=74).The primary endpoints were intensive care unit(ICU) stay and hospital stay.The secondary endpoints were as follows:operative time,anhepatic phase time,intraoperative blood loss,intraoperative blood transfusion volume,postoperative complications,readmission rate,and postoperative mortality.RESULTS:There was no significant difference in preoperative demographics between the two groups.The median ICU stay was 2 days(range 1-7 days) in the FT group and 5 days(range 3-12 days) in the NFT group(P<0.01).Furthermore,the hospital stay was also significantly reduced in the FT group(P<0.01).The operative time,anhepatic phase time,intraoperative blood loss,and intraoperative blood transfusion volume were decreased in the FT group compared with the NFT group(P<0.05).Based on Spearman correlation analysis,the ICU stay and hospital stay may be positively correlated with operative time,anhepatic phase time and intraoperative blood loss.There were no differences in the incidence of postoperative complications,readmissions,and postoperative mortality between the two groups.CONCLUSION:Fast-track procedures effectively reduce the ICU stay and hospital stay without adversely affecting prognosis.This study demonstrated that fast-track protocols are safe and feasible in liver transplantation. 关键词：FAST-TRACK surgery liver TRANSPLANTATION SURGICAL drainage ICU DAYS hospital stay

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Effects of multimodal fast-track surgery on liver transplantation outcomes

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