王贵和， Email: firstname.lastname@example.org
Objective: To investigate the efficacy of using enhanced recovery after surgery (ERAS) in laparoscopic assisted radical resection for gastric cancer and its influence on postoperative recovery, nutritional status and stress parameters of the patients.
Methods: Eighty patients with gastric cancer scheduled to undergo laparoscopic assisted radical resection from December 2016 to December 2018 were prospectively enrolled, and were randomly allocated to conventional group and ERAS group, with 40 cases in each group. Patients in conventional group underwent the traditional perioperative management, and those in ERAS group received ERAS perioperative management. The relevant perioperative clinical variables, the changes in postoperative levels of serum albumin (ALB), C-reactive protein (CRP), interleukin 6 (IL-6) and procalcitonin (PCT), as well as the changes in body weight ratio (BWR) before and after operation were compared between the two groups of patients.
Results: All preoperative data between the two groups of patients showed no significant difference (all P>0.05). There were no significant differences between the two groups of patients in terms of operative procedures, anastomosis methods, operative time, intraoperative blood loss, number of the resected lymph nodes, postoperative pathological stages, and tumor size (all P>0.05), but the total volume of intraoperative fluid infusion, time to the first postoperative gas passage, time to the first postoperative defecation, length of time of postoperative venous infusion, length of postoperative hospital stay and hospitalization cost were significantly reduced in ERAS group compared with conventional group (all P<0.05). The ALB level was significantly higher on postoperative day (POD) 7, the levels of CRP, IL-6 and PCT were significantly lower on POD 1, 3 and 7, and the BWR value was significantly higher on POD 7 in ERAS group than those in conventional group (all P<0.05).
Conclusion: Using ERAS protocol in laparoscopic assisted radical resection for gastric cancer is safe and effective, and is also superior to the traditional mode in promoting postoperative recovery, improving the nutritional status and reducing the stress response of the patients.
程康文, 王贵和, 束宽山, 郑明, 刘红霞, 唐爱平, 左伯海, 王振兴, 王亚娟, 胡文君, 马冬花.加速康复外科在腹腔镜辅助胃癌根治术中的应用及其对患者术后恢复、营养及应激的影响[J].中国普通外科杂志,2019,28(10):1228-1236.