The Application Effect Of Enhanced Recovery In The Laparoscopic Staging Of Early Endometrial Cancer

Objective:To explore the application safety and effectiveness of enhanced recovery in the laparoscopic staging of early endometrial cancer.Methods: Collected 102 cases of patients with clinical and pathological diagnosis of early endometrial cancer(stage I)and under the laparoscopy staging of early endometrial cancer,in the Dalian Obstetrics and Gynecology Hospital.Among them,55 patients from August 2018 to August 2019 were used as the study group with enhanced recovery implement the management measures during perioperative period;47 patients from August 2017 to July 2018 were used as the control group with traditional implement the management measures during perioperative period;Comparing the situation of postoperative recovery,nutritional status,pain and stress response,postoperative complications,hospitalization costs and readmission rate between the two groups.Results: Before operation,the general clinical conditions of the two groups,such as age,BMI,MNA score,SAS score,Caprini score,preoperative stress response index,pathological classification,pathological stage and operation mode were basically the same,which the differences were not statistically significant(P >0.05).During the operation,the time of operation,the time of anesthesia,the amount of bleeding of the two groups were basically the same,which the differences were not statistically significant(P >0.05).The intraoperative temperature of the study group was(36.47±0.16)? and that of the control group was(36.28±0.26)?,the study group having more stable temperature and the lower incidence of hypothermia,which the differences were statistically significant(P <0.05).After operation,the first drinking time of the study group was(3.13 ± 1.89)h and that of the control group was(7.02 ± 1.01)h;the first feeding time of the study group was(8.98 ± 4.13)h and that of the control group was(14.6 ± 0.92)h;the first time of getting out of bed activity of the study group was(11.33 ± 2.80)h and that of the control group was(15.70 ± 1.77)h;the first drainage time of the study group was(2.00 ± 0.51)days and that of the control group was(2.21 ± 0.46)days,the first defecation time of the study group was(2.21 ± 1.41)days and that of the control group was(4.44 ± 1.13)days;the time of indwelling drainage tube of the study group was(3.20 ± 1.71)days and that of the control group was(7.66 ± 2.72)days,the study group having shortened the time of first feeding,the time of first activity of getting out of bed,the time of first farting,the time of first defecation and the time of indwelling drainage tube(P<0.05).The nutritional status indexes of the two groups were basically the same,which the differences were not statistically significant,but the nutritional status indexes of the control group was significantly lower than that of the study group,during the three days after operation,the albumin of the study group was(35.11 ± 3.26)g / L and that of the control group was(30.08 ± 2.68)g / L;the total protein of the study group was(62.63 ± 5.26)g / L and that of the control group was(52.18 ± 4.26)g / L;the cholesterol of the study group was(4.88 ± 0.70)g / L and that of the control group was(4.24 ± 0.60)g / L,during the three days after operation,all of serum albumin,total protein and cholesterol were lower than those of the study group(P < 0.05).During the preoperative and postoperative,the stress response indexes of the two groups were basically the same,which the differences were not statistically significant.During the three days after operation,the leukocyte of the study group was(6.46 ± 1.66)109 / L and that of the control group was(9.01 ± 2.32)109 / L,the change of leukocyte of the study group was smaller than that of the control group(P < 0.05).The pain duration of the Study group was(2.56±1.34)days and that of the control group was(3.23±1.60)days.The study group had lower score of VAS and shorter pain duration(P < 0.05).The study group had lower the incidence of postoperative complications,chills,fever,nausea and vomiting(P<0.05),the incidence of deep venous thrombosis of the two groups were basically the same,which the differences were not statistically significant(P>0.05).The hospitalization time of the study group was(11.96 ± 2.35)days and that of the control group was(15.87 ± 3.62)days;the hospitalization expenses of the study group were(36214.90 ± 3435.41)yuan and that of the control group were(38280.95 ± 4157.34)yuan;the study group having shorter the hospitalization time and lower cost(P < 0.05).The readmission rate of the two groups were basically the same,which the differences were not statistically significant(P >0.05).Conclusion: It is safe and effective to imply the enhanced recovery management measures for early stage endometrial cancer(stage I)in the laparoscopic staging of early endometrial cancer,which can effectively stabilize the internal environment of patients,reduce the psychological and physiological trauma stress response,accelerate the recovery of patients,reduce complications,hospitalization time and medical costs.