Effect of preoperative oral high glucose solution on postoperative recovery, HOMA-IR and serum hsCRP level of patients with gastric cancer / 中华内分泌外科杂志

ABSTRACT

Objective:To investigate the effects of preoperative oral high glucose solution on postoperative recovery, homeostasis model assessment-insulinresistance and high sensitivity C-reactive protein level in patients with gastric cancer.Methods:A total of 83 patients with gastric cancer diagnosed and treated in Hefei Hospital of Anhui Medical University from Jan. 2018 to Jun. 2020 were selected and divided into study group (42 cases) and control group (41 cases) according to whether or not they were given oral glucose solution before operation. In the first 4 hours, 500 ml of 10% glucose solution (glucose solution, GS) was taken orally, and the control group did not take it before surgery. The postoperative recovery (time of first exhaust after operation, time of first defecation, length of hospitalization after operation) , postoperative complications, HOMA-IR and serum hsCRP levels between the two groups were observed and compared.Results:The two groups had very small differences in general information such as gender, age, BMI, TNM staging, and surgical methods ( P>0.05) . In comparison of HOMA-IR index, before treatment, the difference of HOMA-IR index between the two groups was small ( P>0.05) ; after treatment, the difference of HOMA-IR index between the two groups increased (1.80±0.45 vs 5.65±1.46 for the study group before and after treatment, 1.92±0.43 vs 11.70±3.05 for the control group before and after treatment) , and the HOMA-IR index of the control group was higher than that of the study group ( P<0.05) . In comparison of hsCRP levels, before treatment, there was little difference in hsCRP levels between the two groups ( P>0.05) ; after treatment, hsCRP levels in the two groups increased (1.23±0.90 vs 40.40±27.05 for the study group before and after treatment, and 1.40±1.15 vs 80.05±38.85 for the control group before and after treatment) , and the hsCRP level of the control group was higher than that of the study group ( P<0.05) . In terms of postoperative recovery, the study group’s first exhaust time, first defecation time, and postoperative hospital stay were significantly shorter than those of the control group [ (3.35±0.50, 4.05±0.50, 14.65±1.90) vs (4.30±0.90, 5.70±1.15, 16.15±2.05) , P<0.05]. In comparison with postoperative complications, the total incidence of postoperative gastric bleeding, anastomotic leakage, intestinal obstruction, and other complications was 11.9% for the study group and the total incidence of complications was 14.63% in the control group ( P>0.05) . Conclusions:After operation, oral GS can reduce insulin resistance and inflammation in patients with gastric cancer. It has positive significance to promote postoperative rehabilitation.