Research Of Enhanced Recovery After Surgery Combined With Laparoscopy-assisted Radcal Gastrectomy For Gastric Cancer

ObjectiveTo investigate the safety and efficacy of enhanced recovey after surgery in laparoscopy-assisted radical gastrectomy for gastric cancer.MethodsOne hundred and sixty patients were selected to the first affiliated hospital of Zhengzhou University and underwent laparoscopic gastrectomy,The operation was performed by the same group of surgeons.Group(ERAS+LAG,80 cases)accepted ERAS management,Group(LAG,80 cases)accepted traditional perioperative management.The clinical indicators of the two groups were recorded:1.Preoperative related indicators:gender,age and tumor location,surgical resection extent;the ALB level and CRP level at 1 day before surgery.2.Surgery related indicators:total intraoperative blood loss,operation time,number of lymph node dissection.3.Postoperative related indicators:postoperative hospital stay,postoperative anal first exhaust time,total hospital costs,complications,tumor TNM staging;the serum albumin(ALB)level at 1day,3day,and 5day after surgery,the CRP level at1day,3day,and 5day,the pain score at 1day,3day,and 5day after surgery(digital rating scale).Results1.There were no significant differences between the two groups in gender,age,tumor location,section extent,and TNM stage(P>0.05).2.There were no significant differences between the two groups in blood loss,operation time and the number of removed lymph nodes(P>0.05).3.Compared with the LAG group,the ERAS+LAG group was connected with shorter postoperative hospital stay[(7.03±1.48)d vs.(8.82±1.80)d,t=-6.924,P=0.000],faster recovery of bowel function[(63.47±10.15)h vs.(74.04±16.17)h,t=-4.95,P=0.000],lower hospitalization costs[(6.23±0.28)million vs.(6.76±0.38)million,t=-9.90,P=0.000];However,there was no significant difference in the incidence of complications between the two groups(8.75%vs.12.50%,x~2=0.592,P=0.442).4.Compared with the LAG group,the ERAS+LAG group was connected with higher the ALB level on the 3rd and 5th day after surgery(P<0.05).There was no significant difference in the level of ALB between the 1day before surgery and the1day after surgery(P>0.05).The postoperative analgesia was good(P<0.05).The postoperative CRP level was lower,but the difference was not statistically significant.(P<0.05).ConclusionThe enhanced recovey after surgery(ERAS)mode is safe and effective for laparoscopic radical gastrectomy.It can promote postoperative gastrointestinal peristalsis,shorten hospitalization stay,reduce stress response and improve nutritional status.ERAS has certain advantage in laparoscopic radical gastrectomy.