Sánchez-Pérez B, Aranda-Narváez JM, Suárez-Muñoz MA, elAdel-delFresno M, Fernández-Aguilar JL, Pérez-Daga JA, Pulido-Roa Y, Santoyo-Santoyo J. Fast-track program in laparoscopic liver surgery: Theory or fact? World J Gastrointest Surg 2012; 4(11): 246-250 [PMID: 23493957 DOI: 10.4240/wjgs.v4.i11.246]
Corresponding Author of This Article
Belinda Sánchez Pérez, MD, PhD, Department of General, Digestive and Transplantation Surgery, University Regional Hospital Carlos Haya, Carlos Haya Avenue s/n, 29010 Málaga, Spain. cirbelinda@gmail.com
Article-Type of This Article
Brief Article
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World J Gastrointest Surg. Nov 27, 2012; 4(11): 246-250 Published online Nov 27, 2012. doi: 10.4240/wjgs.v4.i11.246
Table 1 Fast track program in laparoscopic liver surgery
Preoperative cares
No liquid intake 8 h before surgery
Administration of anaesthetic premedication
Intraoperative cares
Control of fluids
Removing nasogastric tube at the end of surgery
No urinary tubes in procedures of < 180 min
Selection of indications of intraabdominal drains
Postoperative cares
Early: ICU/recovery room
Oral intake 6-8 h after the surgery
Mobilization 6-8 h after the surgery
Analgesia: intravenous metamizol/8 h + intravenous paracetamol/8 h within the first 24 h and then oral analgesia
Removal of drains (when used) 24-48 h
Blood test 24 h after (haemogram, coagulation and hepatic profile)
Table 2 Demographic data n (%)
Control group (n = 17)
Fast-track group (n = 26)
P value
Age (yr)
52.5 (29-84)
58.3 (29-77)
NS
Sex (M:F)
10:7
15:11
NS
ASA
NS
II
8 (47.05)
13 (50)
III
9 (52.94)
13 (50)
Indication
< 0.05
Benign/malignant
14 (82.4)/ 3 (17.6)
14 (53.8)/ 12 (45.2)
Pathology
Haemangioma
1
1
Hidatidosis
1
2
FNH
6
4
HCC
3
3
ColangioCa
0
1
Metastasis
0
8
Policystosis/simple cyst
5
7
Others
1
0
Table 3 Surgical procedure results n (%)
Control group (n = 17)
Fast-track group (n = 26)
P value
Technique
NS
Left lateral sectionectomy
4 (23.5)
5 (19.2)
Atypical resection
7 (41.2)
12 (46.2)
Unroofing
5 (29.4)
7 (26.9)
Cystopericystectomy
1 (5.9)
2 (7.7)
Surgery time, min (range)
177 (80-300)
180 (60-345)
NS
Conversion
2 (11.8)
5 (19.2)
NS
Pringle
5 (29.4)
7 (26.9)
NS
Transfusion
1 (5.8)
5 (19.2)
< 0.05
Drains
15 (88.2)
6 (23.1)
< 0.000
ICU
12 (70.6)
4 (15.4)
< 0.000
Table 4 Complications, postoperative stay, morbidity and mortality n (%)
Control group (n = 17)
Fast-track group (n = 26)
P value
Postoperative stay
3 (1-22)
2.5 (1-39)
NS
< 3 d
10 (58.8)
7 (41.2)
> 3 d
21 (80.8)
5 (19.2)
Complications
2 (11.8)
3 (11.5)
NS
Readmissions
1 (5.8)
1 (3.8)
NS
Mortality
0
0
Citation: Sánchez-Pérez B, Aranda-Narváez JM, Suárez-Muñoz MA, elAdel-delFresno M, Fernández-Aguilar JL, Pérez-Daga JA, Pulido-Roa Y, Santoyo-Santoyo J. Fast-track program in laparoscopic liver surgery: Theory or fact? World J Gastrointest Surg 2012; 4(11): 246-250