Программа ускоренного выздоровления хирургических больных: роль модуляции хирургического ответа

1. Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: a review. JAMA Surg 2017; 152 (3): 292–8. https://doi.org/10.1001/jamasurg.2016.4952
2. Пасечник И.Н., Назаренко А.Г., Губайдуллин Р.Р. и др. Современные подходы к ускоренному восстановлению после хирургических вмешательств. Доктор.ру. Анестезиология и реаниматология. Медицинская реабилитация. 2015; 15 (116); 16 (117): 10–7.
[Pasechnik I.N., Nazarenko A.G., Gubaidullin R.R. et al. Sovremennye podkhody k uskorennomu vosstanovleniiu posle khirurgicheskikh vmeshatel'stv. Doktor.ru. Anesteziologiia i reanimatologiia. Meditsinskaia reabilitatsiia. 2015; 15 (116); 16 (117): 10–7 (in Russian).]
3. Сизоненко Н.А., Суров Д.А., Соловьев И.А. и др. Эволюция концепции ускоренного восстановления после операции: от истоков учения о стрессе до использования в неотложной хирургии (обзор литературы). Хирургия. Журн. им. Н.И.Пирогова. 2018; 11: 71–9. https://doi.org/10.17116/hirurgia201811171
[Sizonenko N.A., Surov D.A., Solov'ev I.A. et al. Evoliutsiia kontseptsii uskorennogo vosstanovleniia posle operatsii: ot istokov ucheniia o stresse do ispol'zovaniia v neotlozhnoi khirurgii (obzor literatury). Khirurgiia. Zhurn. im. N.I.Pirogova. 2018; 11: 71–9. https://doi.org/10.17116/hirurgia201811171 (in Russian).]
4. Затевахин И.И., Пасечник И.Н. Программа ускоренного выздоровления в хирургии (fast trak) внедрена. Что дальше? Вестн. хирургии им. И.И.Грекова. 2018; 177 (3): 70–5. https://doi.org/10.24884/0042-4625-2018-177-3-70-75
[Zatevakhin I.I., Pasechnik I.N. Programma uskorennogo vyzdorovleniia v khirurgii (fast trak) vnedrena. Chto dal'she? Vestn. khirurgii im. I.I.Grekova. 2018; 177 (3): 70–5. https://doi.org/10.24884/0042-46252018-177-3-70-75 (in Russian).]
5. Овечкин А.М. Хирургический стресс-ответ, его патофизиологическая значимость и способы модуляции. Регионарная анестезия и лечение острой боли. 2008; 2: 49–62.
[Ovechkin A.M. Khirurgicheskij stress-otvet, ego patofiziologicheskaya znachimost’ i sposoby modulyacii. Regionarnaya anesteziya i lechenie ostroj boli. 2008; 2: 49–62 (in Russian).]
6. Gillis C, Carli F. Promoting perioperative metabolic and nutritionalcare. Anesthesiology 2015; 123: 1455–72.
7. Soop M, Nygren J, Thorell A, Ljungqvist O. Stress-induced insulin resistance: recent developments. Curr Opin Clin Nutr Metab Care 2007; 10: 181–6.
8. Zhong J-X, Kang K, Shu X-L. Effect of nutritional support on clinical outcomes in perioperative malnourished patients: a meta-analysis. Asia Pacific J Clin Nutrition 2015; 24: 367–78.
9. Ljungqvist O, Jonathan E. Rhoads lecture 2011: Insulin resistance and enhanced recovery after surgery. JPEN J Parenter Enteral Nutr 2012; 36: 389–98.
10. Himsworth H, Kerr R. Insulin-sensitive and insulin-insensitive types of diabetes mellitus. Clin Sci 1939; 4: 119–52.
11. Тарасова И.А., Шестаков А.Л., Никода В.В. Инсулинорезистентность после хирургических вмешательств (обзор литературы). Сахарный диабет. 2017; 20 (2): 119–25.
[Tarasova I.A., Shestakov A.L., Nikoda V.V. Insulinorezistentnost' posle khirurgicheskikh vmeshatel'stv (obzor literatury). Sakharnyi diabet. 2017; 20 (2): 119–25 (in Russian).]
12. Tsao TS, Burcelin R, Katz EB et al. Enhanced Insulin Action Due to Targeted GLUT4 Overexpression Exclusively in Muscle. Diabetes 1996; 45 (1): 28–36. DOI: 10.2337/diab. 45.1.28
13. Sato H, Carvalho G, Sato T et al. The association of preoperative glycemic control, intraoperative insulin sensitivity, and outcomes after cardiac surgery. J Clin Endocrinol Metab 2010; 95: 4338–44. DOI: 10.1210/jc.2010-0135
14. Jackson RS, Amdur RL, White JC, Macsata RA. Hyperglycemia is associated with increased risk of morbidity and mortality after colectomy for cancer. J Am Coll Surg 2012; 214: 68–80.
15. Пасечник И.Н., Рябов А.Л., Вершинина М.Г. Сепсис и сахарный диабет: состояние проблемы. Хирургия. Журн. им. Н.И.Пирогова. 2016; 1: 80–4.
[Pasechnik I.N., Riabov A.L., Vershinina M.G. Sepsis i sakharnyi diabet: sostoianie problemy. Khirurgiia. Zhurn. im. N.I.Pirogova. 2016; 1: 80–4 (in Russian).]
16. Горн М.М., Хейтц У.И., Сверингер П.П. Водно-электролитный и кислотно-основной обмен. СПб.: Невский Диалект; М.: БИНОМ, 2000.
[Gorn M.M., Kheitts U.I., Sveringer P.P. Vodno-elektrolitnyi i kislotno-osnovnoi obmen. SPb.: Nevskii Dialekt; M.: BINOM, 2000 (in Russian).]
17. Kwon S, Thompson R, Dellinger P et al. Importance of perioperative glycemic control in general surgery: A report from the Surgical Care and Outcomes Assessment Program. Ann Surg 2013; 257: 8–14.
18. Brandi LS, Frediani M, Oleggini M et al. Insulin resistance after surgery: Normalization by insulin treatment. Clin Sci (Lond) 1990; 79: 443–50.
19. Finfer S, Chittock DR, Su SY et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med 2009; 360: 1283–97.
20. Kao LS, Meeks D, Moyer VA, Lally KP. Peri-operative glycaemic control regimens for preventing surgical site infections in adults. Cochrane Database Syst Rev 2009; 3: CD006806.
21. Maltby JR. Fasting from midnight – the history behind the dogma. Best Pract Res Clin Anaesthesiol 2006; 20: 363–78. http://dx.doi.org/10.1016/j.bpa.2006.02.001
22. Read NW, Houghton LA. Physiology of gastric emptying and pathophysiology of gastroparesis. Gastroenterol Clin North Am 1989; 18: 359–73.
23. Brady MC, Kinn S, Stuart P, Ness V. Preoperative fasting for adults to prevent perioperative complications (Review). The Cochrane Collaboration. JohnWiley & Sons, Ltd.
24. Smith I, Kranke P, Murat I et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 2011; 28 (8): 556–69.
25. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures. Anesthesiology 2017; 126: 376–93.
26. Ljungqvist O, Thorell A, Gutniak M et al. Glucose infusion instead of preoperative fasting reduces postoperative insulin resistance [review]. J Am Coll Surg 1994; 178: 329–36.
27. Yamasaki K, Inagaki Y, Mochida S et al. Effect of intraoperative acetated Ringer's solution with 1% glucose on glucose and protein metabolism. J Anesth 2010; 24 (3): 426–31. DOI: 10.1007/s00540-010-0926-1
28. Yamamoto T, Yoshida M, Watanabe S, Kawahara H. Effects of intraoperative administration of carbohydrates during long-duration oral and maxillofacial surgery on the metabolism of carbohydrates, proteins, and lipids. Oral Maxillofac Surg 2015; 19 (4): 417–21. DOI: 10.1007/s10006-015-0517-2
29. Затевахин И.И., Пасечник И.Н., Ачкасов С.И. и др. Клинические рекомендации по внедрению программы ускоренного выздоровления пациентов после плановых хирургических вмешательств на ободочной кишке. М.: НП «Русмедикал групп», 2016.
[Zatevakhin I.I., Pasechnik I.N., Achkasov S.I. et al. Klinicheskie rekomendatsii po vnedreniiu programmy uskorennogo vyzdorovleniia patsientov posle planovykh khirurgicheskikh vmeshatel'stv na obodochnoi kishke. Moscow: NP “Rusmedikal grupp”, 2016. (in Russian).]
30. Ljungqvist O, Nygren J, Thorell A. Modulation of post-operative insulin resistance by pre-operative carbohydrate loading. Proc Nutr Soc 2002; 61 (3): 329–36. DOI: 10.1079/ PNS2002168
31. Ljungqvist O, Nygren J, Thorell A et al. Preoperative nutrition – Elective surgery in the fed or the overnight fasted state. Clin Nutr 2001; 20: 167–71.
32. Jenkins DJ, Wolever TM, Ocana AM et al. Metabolic effects of reducing rate of glucose ingestion by single bolus versus continuous sipping. Diabetes 1990; 39: 775–81.
33. Nygren J, Thorell A, Jacobsson H et al. Preoperative gastric emptying. Effects of anxiety and oral carbohydrate administration. Ann Surg 1995; 222: 728–34.
34. Hill LT, Miller MGA. Carbohydrate loading in the preoperative setting. S Afr Med J 2015; 105 (3): 173–4. DOI:10.7196/SAMJ.8746
35. Perrone F, da-Silva-Filho AC, Adôrno IF et al. Effects of preoperative feeding with a whey protein plus carbohydrate drink on the acute phase response and insulin resistance: A randomized trial. Nutr J 2011; 10: 66. http://dx.doi.org/10.1186/1475-2891-10-66
36. Пасечник И.Н., Мещеряков А.А., Рыбинцев В.Ю., Кулаков В.В. Голодание перед плановой операцией: за и против. Хирургия (Прил. к журн. Consilium Medicum). 2018; 1: 31–34. DOI: 10.26442/2414-3618_2018.1.31-34
[Pasechnik I.N., Meshcheryakov A.A., Rybintsev V.Yu., Kulakov V.V. Fasting before a planned operation: pros and cons. Surgery (Suppl. Consilium Medicum). 2018; 1: 31–34. DOI: 10.26442/2414-3618_2018.1.31-34 (in Russian).]
37. Wang ZG, Wang Q, Wang WJ, Qin HL. Randomized clinical trial to compare the effects of preoperative oral carbohydrate versus placebo on insulin resistance after colorectal surgery. Br J Surg 2010; 97: 317–27.
38. Smith MD, McCall J, Plank L et al. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev 2014 (8): CD009161.
 DOI: 10.1002/14651858.CD009161.pub2
39. Svanfeldt M, Thorell A, Hausel J et al. Randomized clinical trial of the effect of preoperative oral carbohydrate treatment on postoperative whole-body protein and glucose kinetics. Br J Surg 2007; 94 (11): 1342–50.
40. Noblett SE, Watson DS, Huong H et al. Preoperative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Dis 2006; 8: 563–9.
41. Awad S, Varadhan KK, Ljungqvist O, Lobo DN. A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery. Clin Nutr 2013; 32: 34–44.
42. Bilku DK, Dennison AR, Hall TC et al. Role of preoperative carbohydrate loading: a systematic review. Ann R Coll Surg Engl 2014; 96: 15–22. DOI: 10.1308/003588414 X13824511650614

________________________________________________

1. Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: a review. JAMA Surg 2017; 152 (3): 292–8. https://doi.org/10.1001/jamasurg.2016.4952
2. Pasechnik I.N., Nazarenko A.G., Gubaidullin R.R. et al. Sovremennye podkhody k uskorennomu vosstanovleniiu posle khirurgicheskikh vmeshatel'stv. Doktor.ru. Anesteziologiia i reanimatologiia. Meditsinskaia reabilitatsiia. 2015; 15 (116); 16 (117): 10–7 (in Russian).
3. Sizonenko N.A., Surov D.A., Solov'ev I.A. et al. Evoliutsiia kontseptsii uskorennogo vosstanovleniia posle operatsii: ot istokov ucheniia o stresse do ispol'zovaniia v neotlozhnoi khirurgii (obzor literatury). Khirurgiia. Zhurn. im. N.I.Pirogova. 2018; 11: 71–9. https://doi.org/10.17116/hirurgia201811171 (in Russian).
4. Zatevakhin I.I., Pasechnik I.N. Programma uskorennogo vyzdorovleniia v khirurgii (fast trak) vnedrena. Chto dal'she? Vestn. khirurgii im. I.I.Grekova. 2018; 177 (3): 70–5. https://doi.org/10.24884/0042-46252018-177-3-70-75 (in Russian).
5. Ovechkin A.M. Khirurgicheskij stress-otvet, ego patofiziologicheskaya znachimost’ i sposoby modulyacii. Regionarnaya anesteziya i lechenie ostroj boli. 2008; 2: 49–62 (in Russian).
6. Gillis C, Carli F. Promoting perioperative metabolic and nutritionalcare. Anesthesiology 2015; 123: 1455–72.
7. Soop M, Nygren J, Thorell A, Ljungqvist O. Stress-induced insulin resistance: recent developments. Curr Opin Clin Nutr Metab Care 2007; 10: 181–6.
8. Zhong J-X, Kang K, Shu X-L. Effect of nutritional support on clinical outcomes in perioperative malnourished patients: a meta-analysis. Asia Pacific J Clin Nutrition 2015; 24: 367–78.
9. Ljungqvist O, Jonathan E. Rhoads lecture 2011: Insulin resistance and enhanced recovery after surgery. JPEN J Parenter Enteral Nutr 2012; 36: 389–98.
10. Himsworth H, Kerr R. Insulin-sensitive and insulin-insensitive types of diabetes mellitus. Clin Sci 1939; 4: 119–52.
11. Tarasova I.A., Shestakov A.L., Nikoda V.V. Insulinorezistentnost' posle khirurgicheskikh vmeshatel'stv (obzor literatury). Sakharnyi diabet. 2017; 20 (2): 119–25 (in Russian).
12. Tsao TS, Burcelin R, Katz EB et al. Enhanced Insulin Action Due to Targeted GLUT4 Overexpression Exclusively in Muscle. Diabetes 1996; 45 (1): 28–36. DOI: 10.2337/diab. 45.1.28
13. Sato H, Carvalho G, Sato T et al. The association of preoperative glycemic control, intraoperative insulin sensitivity, and outcomes after cardiac surgery. J Clin Endocrinol Metab 2010; 95: 4338–44. DOI: 10.1210/jc.2010-0135
14. Jackson RS, Amdur RL, White JC, Macsata RA. Hyperglycemia is associated with increased risk of morbidity and mortality after colectomy for cancer. J Am Coll Surg 2012; 214: 68–80.
15. Pasechnik I.N., Riabov A.L., Vershinina M.G. Sepsis i sakharnyi diabet: sostoianie problemy. Khirurgiia. Zhurn. im. N.I.Pirogova. 2016; 1: 80–4 (in Russian).
16. Gorn M.M., Kheitts U.I., Sveringer P.P. Vodno-elektrolitnyi i kislotno-osnovnoi obmen. SPb.: Nevskii Dialekt; M.: BINOM, 2000 (in Russian).
17. Kwon S, Thompson R, Dellinger P et al. Importance of perioperative glycemic control in general surgery: A report from the Surgical Care and Outcomes Assessment Program. Ann Surg 2013; 257: 8–14.
18. Brandi LS, Frediani M, Oleggini M et al. Insulin resistance after surgery: Normalization by insulin treatment. Clin Sci (Lond) 1990; 79: 443–50.
19. Finfer S, Chittock DR, Su SY et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med 2009; 360: 1283–97.
20. Kao LS, Meeks D, Moyer VA, Lally KP. Peri-operative glycaemic control regimens for preventing surgical site infections in adults. Cochrane Database Syst Rev 2009; 3: CD006806.
21. Maltby JR. Fasting from midnight – the history behind the dogma. Best Pract Res Clin Anaesthesiol 2006; 20: 363–78. http://dx.doi.org/10.1016/j.bpa.2006.02.001
22. Read NW, Houghton LA. Physiology of gastric emptying and pathophysiology of gastroparesis. Gastroenterol Clin North Am 1989; 18: 359–73.
23. Brady MC, Kinn S, Stuart P, Ness V. Preoperative fasting for adults to prevent perioperative complications (Review). The Cochrane Collaboration. JohnWiley & Sons, Ltd.
24. Smith I, Kranke P, Murat I et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 2011; 28 (8): 556–69.
25. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures. Anesthesiology 2017; 126: 376–93.
26. Ljungqvist O, Thorell A, Gutniak M et al. Glucose infusion instead of preoperative fasting reduces postoperative insulin resistance [review]. J Am Coll Surg 1994; 178: 329–36.
27. Yamasaki K, Inagaki Y, Mochida S et al. Effect of intraoperative acetated Ringer's solution with 1% glucose on glucose and protein metabolism. J Anesth 2010; 24 (3): 426–31. DOI: 10.1007/s00540-010-0926-1
28. Yamamoto T, Yoshida M, Watanabe S, Kawahara H. Effects of intraoperative administration of carbohydrates during long-duration oral and maxillofacial surgery on the metabolism of carbohydrates, proteins, and lipids. Oral Maxillofac Surg 2015; 19 (4): 417–21. DOI: 10.1007/s10006-015-0517-2
29. Zatevakhin I.I., Pasechnik I.N., Achkasov S.I. et al. Klinicheskie rekomendatsii po vnedreniiu programmy uskorennogo vyzdorovleniia patsientov posle planovykh khirurgicheskikh vmeshatel'stv na obodochnoi kishke. Moscow: NP “Rusmedikal grupp”, 2016. (in Russian).
30. Ljungqvist O, Nygren J, Thorell A. Modulation of post-operative insulin resistance by pre-operative carbohydrate loading. Proc Nutr Soc 2002; 61 (3): 329–36. DOI: 10.1079/ PNS2002168
31. Ljungqvist O, Nygren J, Thorell A et al. Preoperative nutrition – Elective surgery in the fed or the overnight fasted state. Clin Nutr 2001; 20: 167–71.
32. Jenkins DJ, Wolever TM, Ocana AM et al. Metabolic effects of reducing rate of glucose ingestion by single bolus versus continuous sipping. Diabetes 1990; 39: 775–81.
33. Nygren J, Thorell A, Jacobsson H et al. Preoperative gastric emptying. Effects of anxiety and oral carbohydrate administration. Ann Surg 1995; 222: 728–34.
34. Hill LT, Miller MGA. Carbohydrate loading in the preoperative setting. S Afr Med J 2015; 105 (3): 173–4. DOI:10.7196/SAMJ.8746
35. Perrone F, da-Silva-Filho AC, Adôrno IF et al. Effects of preoperative feeding with a whey protein plus carbohydrate drink on the acute phase response and insulin resistance: A randomized trial. Nutr J 2011; 10: 66. http://dx.doi.org/10.1186/1475-2891-10-66
36. Pasechnik I.N., Meshcheryakov A.A., Rybintsev V.Yu., Kulakov V.V. Fasting before a planned operation: pros and cons. Surgery (Suppl. Consilium Medicum). 2018; 1: 31–34. DOI: 10.26442/2414-3618_2018.1.31-34 (in Russian).
37. Wang ZG, Wang Q, Wang WJ, Qin HL. Randomized clinical trial to compare the effects of preoperative oral carbohydrate versus placebo on insulin resistance after colorectal surgery. Br J Surg 2010; 97: 317–27.
38. Smith MD, McCall J, Plank L et al. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev 2014 (8): CD009161.
DOI: 10.1002/14651858.CD009161.pub2
39. Svanfeldt M, Thorell A, Hausel J et al. Randomized clinical trial of the effect of preoperative oral carbohydrate treatment on postoperative whole-body protein and glucose kinetics. Br J Surg 2007; 94 (11): 1342–50.
40. Noblett SE, Watson DS, Huong H et al. Preoperative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Dis 2006; 8: 563–9.
41. Awad S, Varadhan KK, Ljungqvist O, Lobo DN. A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery. Clin Nutr 2013; 32: 34–44.
42. Bilku DK, Dennison AR, Hall TC et al. Role of preoperative carbohydrate loading: a systematic review. Ann R Coll Surg Engl 2014; 96: 15–22. DOI: 10.1308/003588414 X13824511650614

И.Н.Пасечник1,2, Е.И.Скобелев1, В.Ю.Рыбинцев1, П.С.Сальников1,2 

1. ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента РФ, Москва, Россия;
2. ФГБУ «Центральная клиническая больница с поликлиникой» Управления делами Президента РФ, Москва, Россия

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Igor N. Pasechnik1,2, Evgeniy I. Skobelev1, Vladimir Iu. Rybintsev1, Pavel S. Salnikov1,2 

1. Central State Medical Academy of the President of the Russian Federation, Moscow, Russia;
2. Central Clinical Hospital with a Polyclinic of the President of the Russian Federation, Moscow, Russia