Application Of Enhanced Recovery After Surgery In Laparoscopic D2 Radical Gastrectomy For Gastric Cancer

【Purpose】The purpose of this research was to investigate clinical application of enhanced recovery after surgery(ERAS)in laparoscopic D2 radical gastrectomy for gastric cancer,and to evaluate the safety and effectiveness of ERAS in laparoscopic D2 radical gastrectomy for gastric cancer.【Method】From January 2020 to December 2022,82 patients with gastric cancer confirmed by gastroscopic pathological biopsy in the gastrointestinal region of our hospital and undergoing laparoscopic D2 radical gastrectomy for gastric cancer were retrospectively analyzed.All patients included in the stud y underwent surgery by the same surgeon group,of which 32 patients were treated using the ERAS concept(ERAS experimental group)during the perioperative management,and 50 patients were treated using the traditional concept(traditional control group)du ring the perioperative management.SPSS26.0 system was used for statistical analysis,and the measurement data were expressed as mean±standard deviation,that is,those with normal distribution passed the t test and those with skew distribution passed th e rank sum test.Count data were compared by x~2 test.P<0.05 was considered statistically significant.The following clinical indicators were analyzed and compared between the two groups:(1)Basic data:gender,age,body mass index(BMI),tumor staging(stages I,II,and III),surgical anastomosis methods(Billroth I,Billroth II,Roux-en-Y);(2)Operation indicators:operation time,intraoperative bleeding volume;(3)Nutritional status and inflammatory indicators:serum albumin(ALB)levels before and on the 3rd day after surgery,and C-reactive protein(CRP)levels before and on the 3rd day after surgery;(4)Postoperative general information:Postoperative anal exhaust time,postoperative oral fluid intake time,hospital stay,pain scores on the 1st,2nd,and 3rd days after surgery NRS pain score;(5)Postoperative complications:incision infection,lung infection,abdominal infection,gastrointestinal fistula,intestinal obstruction,lower limb venous thrombosis,aspiration pneumonia,urinary tract in fection.【Result】There was no statistically significant difference in basic data between the two groups(P>0.05).There was no significant difference in operative time and intraoperative bleeding volume between ERAS group and traditional group(P>0.05).There was no significant difference in preoperative ALB and CRP counts between the two groups(P>0.05).The amount of ALB in the ERAS group on the 3rd day after surgery was higher than that in the traditional group(P<0.05).The amount of CRP in ERAS group w as lower than that in traditional group on the 3rd day after operation(P<0.05).Postoperative anal exhaust time and postoperative oral fluid intake time in the ERAS group were all earlier than those in the traditional group(P<0.05),and hospitalization time in the ERAS group was shorter than those in the traditional group(P<0.05).The NRS scores on the 1st,2nd,and 3rd days after surgery in the ERAS group were lower than those in the traditional group,with a statistically significant difference(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).【Conclusion】The application of ERAS in laparoscopic D2 radical gastrectomy for gastric cancer can improve patient nutritional status,alleviate postoperative stress response,accelerate the recovery of digestive tract function,alleviate postoperative pain,shorten hospital stay,and do not increase the incidence of postoperative complications.Application of ERAS in laparoscopic D2 radical gastrectomy for gastric cancer can effectively accelerate postoperative rehabilitation of patients,and is safe and feasible.