Application Of ERAS Concept In 3D Laparoscopic Radical Gastrectomy For Gastric Cancer

Objective: To evaluate the clinical value of the concept of ERAS in 3 D laparoscopic radical gastrectomy for gastric cancer.Methods: The clinical data of 110 patients with gastric cancer who underwent 3D laparoscopic surgery from September 2015 to November 2017 in our hospital were collected.The patients in ERAS group(48 cases)and traditional group(62 cases)were treated with accelerated rehabilitation surgery under the guidance of the idea of accelerated rehabilitation surgery,while the patients in traditional group were treated according to traditional idea.The operative parameters of the two groups were compared and analyzed: operative time,intraoperative bleeding volume and number of lymph node dissection.Postoperative clinical outcome: pain score in the first three days after operation(using digital pain score scale NRS),to remove urinary catheter time,get out of bed activity time,first exhaust time through anus,oral feeding time,hospital expenses,complications.Laboratory indicators: WBC and reactive protein(CRP)levels 1 day before operation,1 day,3 days,5 days in peripheral blood after operation.Results: 1.There was no significant difference between the two groups in the operation time,the amount of blood loss and the number of lymph node dissection(P>0.05).2.Compared with the traditional group,The extraction time of urinary catheter in ERAS group was earlier [(2.42±0.50)d vs.(2.65±0.52)d,P=0.021],the time of getting out of bed is earlier [(2.67±0.60)d vs.(3.03±0.54)d,P=0.001],postoperative first exhaust time is earlier[(3.60±0.80)d vs.(4.03±0.63)d,P=0.003],oral feeding time in advance[(1.63±0.50)d vs.(4.03±0.63)d,P=0.000],the time of removal of abdominal drainage tube is earlier[(5.44±1.51)d vs.(8.31±1.05)d,P=0.000],shorter hospital stay[(9.35±1.16)d vs.(10.98±1.52)d,P=0.000],lower hospitalization costs[(7.83±0.53)ten thousand yuan vs.(8.16±0.64)ten thousand yuan,P=0.004],the incidence of the postoperative complications was not not increased,but slightly lower,the difference was not statistically significant(P > 0.05).3.Compared with the traditional group,the postoperative pain was lighter and the analgesic effect was more obvious in the ERAS group(P < 0.05).The peripheral blood leukocyte count and CRP level were slightly lower than those in the traditional group,but the difference was not significant(P > 0.05).Conclusion:1.The application of ERAS in 3D laparoscopic radical gastrectomy for gastric cancer is safe and feasible.2.The application of ERAS in 3D laparoscopic radical gastrectomy can relieve postoperative pain effectively,shorten the recovery time of postoperative gastrointestinal function,shorten the hospitalization time and reduce the cost of hospitalization.3.The concept of ERAS has obvious advantages and has a wide application prospect,which is worth popularizing.