Influence Of Enhanced Recovery After Surgery On Perioperative Stress And Immune Function In Patients With Gastric Cancer

Objective: Observe the influence of enhanced recovery after surgery on postoperative inflammatory and immune indexes in patients with gastric cancer undergoing gastrectomy,to explore the effect of enhanced recovery after surgery on perioperative stress and immune function in patients with gastric cancer.Methods: Choose 80 patients with gastric cancer underwent laparoscopic assisted gastrectomy in Affiliated Hospital of Qinghai University from November 2017 to November 2018,.The patients were randomly divided into enhanced recovery after surgery group(ERAS group,n = 40)and routine group(NO-ERAS group,n = 40).And include the relevant management path.The data of enrolled cases were recorded: time of first flatus after surgery,the time of hospitalization and the total cost of hospitalization.the blood samples of anterior cubital vein were collected in the morning at one day before operation and the 1st,3rd and 5th day after operation,the concentrations of WBC,NEUT%,serum CRP,complement C3,complement C4,immunoglobulin A,immunoglobulin G and immunoglobulin M were recorded.The effects of enhanced recovery after surgery on the two groups were compared.Results:(1)There was no significant difference in age,gender composition,tumor stage,surgical procedure and anastomosis.time of first flatus after surgery hospitalization time and total hospitalization cost in the ERAS group were shorter than those in the NO-ERAS group(p<0.05).(2)There were no significant differences in preoperative WBC,NEUT%,serum CRP,complement C3,complement C4,immunoglobulin A,immunoglobulin G,immunoglobulin M between the two groups(p>0.05).(3)There were significant differences in inflammatory indexes(WBC,NEUT%,serum CRP)between the two groups,which were higher after operation than those before operation.the peak value of NO-ERAS group was higher and the recovery was slower.There was significant difference between the two groups at each time point after operation(p < 0.05).(4)There were significant differences in complement C3,complement C4,IgA and IgG between the two groups(p < 0.05),There were no significant differences in IgM between the two groups(p>0.05),.There was no significant difference in preoperative complement and immunoglobulin levels between the two groups(p > 0.05).There was significant difference in complement C3,complement C4,IgA and IgG between the two groups at each time point after operation(p < 0.05),especially in the NO-ERAS group,but there was no significant difference in IgM among the groups at each time point after operation.Conclusion: Enhanced recovery after surgery is helpful to the early rehabilitation of patients with gastric cancer after operation.it plays a positive role in reducing postoperative stress response and protecting immune function.