Application of enhanced recovery after surgery in laparoscopy-assisted distal gastrectomy / 肿瘤研究与临床

ABSTRACT

Objective To evaluate the feasibility and efficacy of enhanced recovery after surgery (ERAS) combined with laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer. Methods 60 patients with distal gastric cancer from April 2016 to September 2016 in Shanxi Cancer Hospital were enrolled. According to the admission time, the patients were numbered randomly by odd and even. 30 odd patients received conventional treatment (traditional group), and were even 30 incorporated into ERAS group. Record and comparison of two groups were conducted, including age, sex, weight, body mass index (BMI), 1-day preoperative serum albumin (ALB) level, operation time, anastomosis type, total intraoperative blood loss, postoperative TNM staging, bowel movement recovery time, postoperative hospital stay, total cost of hospitalization, complications, and serum ALB level after operation. Results The level of ALB in ERAS group was (36.16 ± 2.46) g/L at 4th day after operation, and (39.61±2.03) g/L at 7th day after operation, which were higher than those in traditional group [(34.38 ±2.31) g/L and (37.98 ±1.96) g/L, respectively], with stable changes and statistical difference (P= 0.006, P= 0.003). The recovery time of intestinal peristalsis in ERAS group was shorter than that in traditional group [(51.23±9.05) h vs. (58.97±9.61) h, P= 0.003], and the total hospitalization cost in ERAS group was less than that in traditional group [(7.23±0.34) × 104 yuan vs. (7.58± 0.37) × 104 yuan, P 0.05). Conclusion The combination of ERAS and laparoscopic-assisted distal gastrectomy is safe and effective compared with traditional ways, which can relieve the stress reaction, promote the recovery of gastrointestinal function, reduce the hospitalization cost, and accelerate the rehabilitation of patients.