| Chapter 1 Implementation of enhanced recovery after surgery strategies in patients colorectal cancerObjective:Retrospective study in therapeutic efficiency and costs of enhanced recovery after surgery program was carried out in colorectal cancer patients.Methods:234 patients who were undergoing colorectal cancer surgery between January 2014 and December 2015 at Guangdong General Hospital,Guangzhou,China,were divided into two groups,group control(111 patients)and group intervention(123 patients),which patients in group intervention received the enhanced recovery after surgery program,while group control followed by tradition way.The surgical recovery indexes like first the time to walk,flatus,oral eating after surgery and postoperative complications,hospitalization days,total cost of hospitalization and readmissions rate were compared between two groups.Results:In group intervention,the first the time to walk,flatus,oral eating after surgery and postoperative complications,hospitalization days and total cost of hospitalization were significantly less or shorter(P<0.05)than those of the group control.There was no significant difference in the incidence of readmissions rate after discharge in 30 days between the two groups(P>0.05).Conclusion:Enhanced recovery after surgery treatment can accelerate postoperative rehabilitation and elevate clinical efficiency in colorectal cancer patients during operation period.Chapter 2 The role of ultrasound-guided transverse abdominis plane blocks in patients undergoing colorectal resectionObjective:To evaluate the effect of ultrasound-guided transverse abdominis plane blocks in patients after colorectal resection.Methods:Two hundred fifty-three patients who were undergoing laparoscopic colorectal cancer surgery between January 2016 and December 2016 at Guangdong General Hospital,Guangzhou,China,were divided into two groups,group control(121 patients)and group intervention(132 patients).Both groups received general anesthesia.All patients received a standardised anesthesia.After anesthesia,patients in group intervention received the US-TAP block with about 40ml 0.375%Ropivacaine injected bilaterally between the internal oblique and transverse abdominis muscles,while the patients in Group Control did not receive the US-TAP block.Each patient was assessed 48h after surgery for Visual Analogue Scale(VAS)(6h,12h,24h,48h),if the VAS score ?5 scores,rescue analgesics will be given.The surgical recovery indexes like first the time to walk,flatus,oral eating after surgery and postoperative hospitalization days were also recorded.Results:No complications related to the US-TAP block were observed.The VAS scores of the group control were significantly higher than those of the group intervention at 6h,12h,and 24h after operation(P<0.05),but not at point 48h(P>0.05).There was significant difference between the two groups in the first the time to walk and flatus(P<0.05),oral eating after surgery and postoperative hospitalization days(P<0.05),but there is no difference in oral eating and postoperative hospitalization days(P>0.05).Conclusion:The study showed that US-TAP block result in a statistically significant decrease in VAS scores at different time points and enhance the recovery after laparoscopic colorectal cancer surgery.Chapter 3 The effect of the ultrasonic transdermal deliver system with Potent purgative decotion with additions in patients after gastrointestinal cancer resectionObjective:To evaluate the effect of the ultrasonic transdermal deliver system with Potent purgative decotion with additions in patients after abdominal surgery.Methods:Patients with gastrointestinal cancer who were underwent laparoscopic surgery were randomly divided into two groups,group control and group intervention.As for the group intervention,patients were treated with ultrasoinc electnic transdermal medication twice a day after surgery until the passage of gas by anus.Then we observed and compared the condition of gastrointestinal function recovery and postoperative complications of the two groups in order to evaluate the safety and efficacy of this treatment method.Results:184 patients were involved in the study,and 87 patients were in group intervention and 81 patients were in were in group finally.The incidence rate of abdominal distention in group intervention was 25.3%and group control was 39.5,showed a significant difference(P<0.05).The first time passage of gas by anus in group was 36.31±17.65h and group control was 46.41 ±28.36h,showed a significant difference(P=0.002).There was no significant difference(P>0.05)in the rate of nausea,vomit,defecate,and postoperative hospitalization days between two group.Conclusion:The ultrasonic transdermal deliver system with Potent purgative decotion with additions can improve postoperative abdominal distension and shorten the passage of gas by anus time. |
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