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Chinese Journal of Colorectal Diseases(Electronic Edition) ›› 2018, Vol. 07 ›› Issue (05): 447-452. doi: 10.3877/cma.j.issn.2095-3224.2018.05.008

Special Issue:

• Original Article • Previous Articles     Next Articles

Clinical study of laparoscopic ″tube-free″ colorectal surgery

Lijun Zheng1, Zhen Hu2, Tao Chang2, Xun Jiang1, Liesheng Lu1, Feng Wang1, Zhongchen Liu1,()   

  1. 1. Department of Gastrointestinal Surgery, Shanghai Tenth People′s Hospital, Shanghai 200072, China
    2. Department of Anaesthesia, Shanghai Tenth People′s Hospital, Shanghai 200072, China
  • Received:2017-12-27 Online:2018-10-25 Published:2018-10-25
  • Contact: Zhongchen Liu
  • About author:
    Corresponding author: Liu Zhongchen, Email:

Abstract:

Objective

To achieve ″tube-free″ by improving the perioperative management of laparoscopic colorectal surgery. The laparoscopic ″tube-free″ colorectal surgery and conventional laparoscopic colorectal surgery which indwelled nasogastric tube, peritoneal drainage tube and urinary catheter postoperative were compared in the postoperative recovery and complications to proof the feasibility and safety of laparoscopic ″tube-free″ colorectal surgery.

Methods

Forty-nine patients with colorectal cancer were randomly divided into conventional indwelling three tube operation group (control group) (twenty-three cases) and "tube-free" operation group (TF group) (twenty-six cases). The baseline characteristics of the patients, the postoperative recovery index, 40-item quality of recovery scoring system (QoR-40) assessment and the postoperative safety index were compared.

Results

There were three patients who had postoperative urinary retention in the TF group. The postoperative days of opioid analgesics (Z=5.241, P<0.001) and days of hospitalization (t=3.2, P=0.002) in the TF group were significantly shorter than those in the control group. The difference was not statistically significant. There was no significant difference in the incidence of complications such as anastomotic leakage, intestinal obstruction, wound infection, pulmonary infection, heart failure, deep vein thrombosis and cardio cerebral vascular accident between the two groups (P>0.05). The total score of QoR-40 at forty-eight hours after operation in the TF group was significantly higher than that in the control group (Z=5.774, P<0.01), and the sub-score of comfort, self-care and pain in the TF group was significantly better than that in the control group (P<0.01).

Conclusion

Conventional indwelling nasogastric tube, catheter and drainage tube after colorectal surgery does not benefit the patients. Laparoscopic ″tube-free″ colorectal surgery which reduces postoperative discomfort, improves patient quality recovery after operation without increasing the occurrence of short-term postoperative complications is a safe and feasible treatment measures.

Key words: Colorectal neoplasms, Laparoscopes, Nasogastric tube, Abdominal drainage, Indwelling catheterization

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