Preliminary Clinical Analysis Of Enhanced Recovery After Surgery For Liver Cancer Resection

Background:In modern surgery,the emergence of Enhanced Recovery After Surgery(ERAS),especially in the successful use of Colorectal surgery,and the innovation of new surgical techniques such as laparoscopic precision minimally invasive surgery,make liver surgery see the dawn of hope in the ERAS.But at present,liver surgery has not yet formed a systematic and effective ERAS diagnosis and treatment model.Objective:We conducted a preliminary clinical study on the ERAS model of liver cancer to evaluate the effectiveness and safety of ERAS in the surgical treatment of liver cancer.Methods:The study was conducted in patients with hepatobiliary surgery at Huzhou Hospital of Zhejiang University from January 2017 to January 2019.Forty-nine patients were randomly divided into experimental groups by randomized controlled trials,and 19 patients in the ERAS group;28 patients in the control group,the traditional surgical group.The experimental group was treated with the ERAS diagnosis mode for perioperative period,and the traditional treatment group was treated with the traditional perioperative treatment mode.The data and data related to the two groups of patients in this study were collected and analyzed separately.The main contents are:age,gender,height,weight,tumor size,alpha-fetoprotein,platelet,prothrombin time,serum albumin,ASA classification,amount of bleeding during surgery,duration,postoperative anal exhaust and defecation time,dietary change time,pain and related complications Incidence,mortality,etc.,as well as the total number of hospital stays and postoperative hospital stay days.Result:In the preoperative data,in the comparison of the general data of age,gender,body mass index(BMI),tumor size,alpha-fetoprotein,platelet,prothrombin time,serum albumin and ASA classification in the ERAS treatment group and the traditional treatment group,p>0.05,the difference was not statistically significant,and the experiment was comparable.In the intraoperative comparison,the duration of surgery in the ERAS treatment group(n=19)was 4.5(4,5.5)h,the intraoperative blood loss was 200(100,250)ml,and the duration of surgery in the conventional treatment group(n=28).For 4.5(4.25,5)h,the amount of surgical bleeding was 250(200,300)ml.After the test,the p values were all greater than 0.05,and there was no statistically significant difference.However,the intraoperative blood loss of ERAS is slightly smaller than the traditional treatment group.In the postoperative data,the incidence of bleeding,biliary fistula,pulmonary infection,and urinary tract infection in the ERAS treatment group(n=19)were 0.05,0.05,0.05,and 0.11,respectively,and the traditional treatment group(n=28)was 0.036.0.036,0.07,0.11,the p value of each group was greater than 0.05,and the total incidence of complications was basically similar,p>0.05,there was no statistically significant difference in postoperative complications.There is no obvious advantage in the ERAS group.However,the postoperative pain discomfort was 0.47 in the ERAS group,which was significantly lower than the 0.79 in the traditional treatment group,p=0.029,with clear statistical significance.No deaths occurred during the postoperative hospital stay in both groups,and all were discharged from hospital.The total length of hospital stay was 17(13,26)d in the ERAS group and 20.5(16.5,24.5)d in the conventional treatment group.The p value of the two groups was 0.155,which was greater than 0.05.There was no statistical significance,and there was no significant difference in the total length of hospital stay.However,patients in the ERAS group had less exhaust time,defecation time,fluid intake time,semi-liquid time,and postoperative hospital stay than the traditional treatment group,the values of p were 0.012,0.01,0.043,0.032and0.01,respectively,suggesting statistical significance.Conclusion:ERAS is effective and safe in the surgical treatment of liver cancer.The ERAS treatment mode can speed up the recovery of patients after the treatment of liver cancer and the complications are not increased,so as to reduce the patient's pain in the hospitalization.