Application of enhanced recovery after surgery in colorectal surgery in municipal hospitals / 肿瘤研究与临床

ABSTRACT

Objective To analyze the feasibility and safety of enhanced recovery after surgery (ERAS) in colorectal surgery in municipal hospitals. Methods The clinical data of patients with colorectal cancer in Zhangzhou Affiliated Hospital of Fujian Medical University from June 2016 to December 2018 were retrospectively analyzed. A total of 50 patients who underwent laparoscopic surgery combined with ERAS in the perioperative period were selected as the ERAS group, and 50 patients who underwent laparoscopic surgery combined with conventional methods in the perioperative period were treated as the control group. The general data were compared in the two groups, including age, gender, body mass index and the tumor site. The postoperative recovery was compared including fart time, defecation time, total fluid food intake time, nutritional indexes, postoperative leaving hospital time. And the postoperative complications were also compared, including wound infection, lung infection, anastomotic fistula, abdominal infection as well as the urinary infection. Results The first fart time and total fluid food intake time in the ERAS group were earlier than those in the control group [(1.5±0.5) d vs. (2.1±0.8) d, (2.2± 0.8) d vs. (3.4±1.6) d], and the differences were statistically significant (t= 4.907, t= 4.604, both P< 0.01). The albumin and hemoglobin in the ERAS group were higher than those in the control group [(32.7 ±3.1) g/L vs. (30.9 ±2.1) g/L, t= -3.188, P= 0.002;(115±3) g/L vs. (103±16) g/L, t= -3.916, P< 0.01], and the postoperative hospital stay in the ERAS group was shorter than that in the control group, and the difference was statistically significant [(7.2±1.2) d vs. (9.5± 3.6) d;t=4.095, P=0.001]. And the incidence of postoperative complications in the ERAS group was lower than that in the control group, and the differences were statistically significant [14％ (7/50) vs. 38％ (19/50),χ2 = 7.484, P= 0.008]. Conclusions ERAS combined with laparoscopic colorectal cancer surgery can accelerate the postoperative rehabilitation, shorten the length of hospital stay, and reduce postoperative complications. It has high feasibility and safety in the application of colorectal surgery in municipal hospitals, but the individualized treatment must be taken into consideration.