The Clinical Study Of Fast Track Surgery In The Perioperative Period For Pediatric Hirschsprung Disease

Objective: Since the concept of FTS was raised in 2001,it has been widely used in the surgical treatment for adult colorectal patients,but it was less reported in pediatric Hirschsprung Disease field.Several studies showed that patients receiving FTS gained enhanced recovery,shorter hospital stays and less cost.The?2015 Chinese Consensus of Enhanced Recovery After Surgery for Colorectal Surgery?also strongly recommends that FTS is a new concept in the 21 st century which is a revolution to the medical treatment and rehabilitation mode and it has been successfully applicated in colorectal surgery.This study would use FTS concept treatment plan and traditional treatment plan to compare the operation time,intraoperative blood loss,first-time exhaust defecation time,hospitalization days,hospitalization expenses and postoperative complications in two groups of children with HD.The serum levels of the two groups of children and the immune function of the children in the FTS group were examined to investigate the degree of stress response caused by surgical trauma during the perioperative period and and the postoperative degree of recoverment of immune functions of children in the FTS group,which is to evaluate the clinical value of FTS concept in the treatment of children with HD.Methods: To review the data of 50 cases of HD children admitted to the Department of Pediatric Surgery,First Hospital of Lanzhou University from January 2004 to December 2005 and from January 2017 to December 2018.According to the difference in perioperative treatment methods,25 HD children admitted from January 2017 to December 2018 were enrolled in the FTS group,and the rest of 25 children with HD admitted from January 2004 to December 2005 were compared in the control group.We compared the amount of intraoperative blood loss,the first postoperative defecation time,the length of hospital stay and hospitalization expenses,postoperative complications,etc.And recorded the serum markers of the two groups and the immune function of the children in the FTS group.Results: Both groups of children were cured and discharged.There was no significant difference in the operation time between the FTS group and the traditional control group(P>0.05).The intraoperative blood loss was significantly reduced(P < 0.05);the first postoperative defecation time was advanced(P < 0.05);The number of hospitalization days and expenses decreased(P < 0.05);however,there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Children in the FTS group were less affected by the degree of stress response and immune function caused by surgical trauma,and the immune function could be restored to normal level in the short term after surgery.Conclusion: The FTS concept is safe and effective in the perioperative treatment of children with HD,which can significantly reduce the amount of intraoperative blood loss,shorten the length of hospital stay and reduce hospitalization costs;reduce the stress response caused by surgical trauma,etc,while the immune function of the body is also less affected,and accelerate the early postoperative rehabilitation of children.The FTS concept will be used in the treatment of children's HD perioperative period,which will benefit the children,and will make the social medical resources more fully and effectively utilized.