The Clinical Application Of ERAS In The Perioperative Period Of Laparoscopic Radical Gastrectomy And Its Effects On Nutritional Indicators And Immune Function

Objective To explore the application of enhanced recovery after surgery(ERAS)in perioperative period of laparoscopic radical gastrectomy,explore the advantages of ERAS,and explore the effect of ERAS combined laparoscopic radical gastrectomy on nutritional index and immune function of gastric cancer patients.Materials and methods In this study,134 patients with gastric cancer admitted by the same group of doctors in the gastrointestinal surgery department of our hospital from January 2016 to December 2016 were taken as the study subjects,this research adopts the prospective randomized controlled study,computer generated random table divided the patients into two groups,namely treated by laparoscopic gastric cancer radical + ERAS(research group)and laparoscopic gastric cancer radical + traditional perioperative treatment(control group);After screening,42 cases were treated with laparoscopic radical gastrectomy +ERAS(research group),after screening,42 cases were treated with laparoscopic radical gastrectomy + traditional perioperative treatment(control group);Compare two groups of patients: postoperative activity out of bed days,postoperative feeding time,postoperative day 3 C-reactive protein(C-reaction protein,CRP),the degree of postoperative pain,anal exhaust time,postoperative TNM staging,total hospitalization expenses,postoperative hospital stay and surgical complications.the nutritional indexes and serum immunoglobulin levels were compared between the two groups before and after operation.Results1.The baseline indicators of the study group and control group,TNM staging,operation mode,Anastomotic methods,operation time,total amount of bleeding in the operation,and the number of lymph node dissection were not statistically significant(P>0.05).2.The difference was statistically significant between the two groups of patients with anal exhaust time,bed activity time after operation,feeding time and postoperative pain level(P<0.05).3.The length of hospitalization and total hospitalization expenses in the study group were significantly lower than that in the control group(P<0.05).4.In the first day after surgery and the 7th day after surgery,the level of Prealbumin(PAB)of the group was compared with that of the first day before surgery,and the difference was statistically significant(P < 0.05).On the 7th day after surgery,the PAB level of the group was significantly higher than that of the control group(P < 0.05).5.In the first day after surgery and the 7th day after surgery,the level of serum Albumin(Albumin,ALB)in the study group was compared with that of the preoperative 1 day,and the difference was statistically significant(P < 0.05).On the 7th day after surgery,the ALB level of the study group was significantly higher than that of the control group(P < 0.05).6.Postoperative day 1,3 days after operation,postoperative day 7,the control group Transferrin(TRF),Retinol binding Protein(Rb P),Hemoglobin(Hb),and immunoglobulin A(Ig A),immunoglobulin M(Ig M)levels significantly lower than the preoperative level of 1 day(P < 0.05)7.1 day before surgery,1 day after surgery,3 days after surgery and 7 days after surgery,there was no significant difference in Hb level between the two groups(P<0 0.05).8.On the third day after surgery and the 7th day after surgery,the research group Rb P,Ig A,Ig G and Ig M level were significantly higher than the control group(P < 0.05).9.On the first day after surgery,the third day after surgery and the 7th day after surgery,the group ALB and TRF were significantly higher than the control group(P < 0.05).On the third day after surgery,the CRP level of the group was significantly lower than that of the control group(P < 0.05).10.The incidence of complications in the study group was lower than that in the control group(19.0%vs28.6%),and the difference between the two groups was not statistically significant(P > 0.05).Conclusion Enhanced recovery after surgery has the advantages of reducing surgical stress,reducing surgical complications,and accelerating postoperative rehabilitation.ERAS combined with laparoscopic radical gastrectomy is safe and feasible.Furthermore,it is further explained that ERAS can improve patients’ perioperative nutritional status and immune function,and have a positive effect on postoperative rehabilitation of patients,which is worthy of clinical promotion.