Laparoscopy Combined With ERAS Pathway Afterileocecal Resection For Crohn's Disease

Background:In recent years,the Enhanced Recovery After Surgery(ERAS)have been successful practice in general surgery,cardiac surgery,orthopedics,gynecology,and other fields.In the field of colorectal cancer,laparoscopic combined with ERAS has been widely accepted.Because of the characteristics of Crohn's disease,the rate of complications is high,the laparoscopy combined with ERAS has not yet widely used in patients with Crohn's disease.Objective:To investigate the easibility,safety and short-term outcome of laparoscopy combined with ERAS in ileocecal resection for Crohn's disease.Methods:Our study prospectively collected clinical data of patients with Crohn's disease who will undergo ileocecal resection From December 2015 to December 2016.They were randomly assigned to ERAS group and Traditional group when they were admission to our hospotial.The perioperative management of the ERAS group includes:no routine fasting preoperative last night,no bowel preparation,no abdominal drains postoperative,early removal of urinary catheter,early semi-solid dietary intake and mobilization,and restrictive fluid management.During the perioperative.The clinical data were collected to compare the difference between the two groups in postoperative exhaust time,postoperative complications,postoperative hospital stay,and postoperative hospital costs,and so on.This study was registered at Clinical Trial(NCT02777034).Results:In the study,20 male,12 female,the average age is 30.5.The 32 petients were all diagnosed with CD,and the lesions were located in the ileocecum.The preoperative data of two groups,such as age,course time,BMI,albumin,CRP,ESR,Smoking history,past medications history were all no significant difference(p>0.05).Nevertheless significant difference was found in some postoperative data,such as postoperative exhaust time(1.75±0.58d vs 3.13±0.89d p=0),passage of first stool(2.25±1.0 vs 4.06±1.29,p=0),postoperative hospital stay(5.19±1.28d vs 9.94±3.33d,p=0),postoperative hospital costs(ten thousand)(2.70±0.50 vs 3.73±0.75,p=0);but,there was no significant difference of postoperative complications between two groups(2(12.5%)vs 2(12.5%),p=1).Conclusion:laparoscopy combined with ERAS in ileocecal resection for Crohn's disease can improve the short-term outcome of patients with Crohn's disease who underwent ileocecal resection.