Clinical Study Of Enchanced Recovery After Surgery In Elderly Patients With Colon Cancer During Perioperative Period

Objective : To compare the safety and effectiveness of enchanced recvery after surgery in elderly patients with colon cancer during perioperative period and to evaluate its effect on postoperative inflammatory response immune function and short-term clinical outcome.Methods : A total of 89 elderly patients with colon cancer of Gastroenterology,affiliated Hospital of Qingdao University from April 2018 to October 2018 in the Department were enrolled in the prospective study.They were randomly divided into ERAS group(n =51,reveiving the concept of enchanced recvery after surgery during the perioperative period)and control group(n = 53,reveiving conventional treatment scheme during the perioperative period).To compare the postoperative fever time,exhaust time,hospital stay,hospitalization expensescomplication morbidity and inflammatory index CRP,TNF-?,IL-6 and immune function index Ig A,Ig G,Ig M,CD4+,CD4+/CD8+ on the1 st,3rd,5th day after the operation between two groups.Results : In the ERAS group,the postoperative fever time [(49.7 ±5.9h)h vs(57.5±5.8)h],the postoperative evacuation time [(59.3 ±7.9)h vs(75.8 ±8.3)h],postoperative length of stay [(4.8 ±1.6)d vs(6.7 ±2.0)d],the cost of hospitalization[(53196.7 ±3105.2)yuan vs(59072.5 ±2949.8)yuan] and the quality of life [(17.9 ±1.5)vs(16.5 ±1.6)] were significantly better than those of the control group and the difference was statistically significant(t = 2.440 ~9.097,P < 0.05).The complication incidence was no statistically significant difference between the two groups [35.29%(18/51)vs 45.28%(24/53),P > 0.05).On one day before operation he levels of inflammatory inndex CRP,TNF-? and IL-6 between the two groups were no statistically significant different(F=0.432~1.139,P > 0.05).The levels of CRP,TNF-? and IL-6 in ERAS group were significantly lower than those in the control group on the 1st,3rd and 5th day after operation and the difference was statistically significant(F=5.226~14.734,P <0.05).There was no significant difference in Ig A,Ig G,Ig M,CD4+and CD4+/CD8+between the two groups on one day before and one day after operation((F=0.156~1.604,P > 0.05).On the 3rd day after operation,the Ig A,Ig G in the ERAS group wassignificantly higher than those in the control group and the difference was statistically significant(F=4.254~5.014,P < 0.05).On the 5th day after operation,the Ig A,Ig G,Ig M and CD4+and CD4+/ CD8+in the ERAS group were significantly higher than those in the control group,the difference was statistically significant(F=5.020~11.612,P < 0.05).Conclusion : It is safe and effective to adopt the enchanced recovery after after surgery in perioperative period of elderly patients with colon cancer,which can improve the short-term clinical outcome of elderly patients,reduce the inflammatory stress reaction,protect the immune function of the body,to achieve the goal of rapid rehabilitation after operation.