Clinical Study For Enhanced Recovery After Surgery In Patients With Colorectal Cancer And Type 2 Diabetes Mellitus

Objective:To investigate the efficacy and safety of enhanced recovery after surgery(ERAS)in patients with colorectal cancer and diabetes mellitus.Methods:Based on a retrospective analysis of 106 patients with colorectal cancer and diabetes mellitus who underwent radical resection of colorectal cancer in the Department of Gastrointestinal Surgery of Shandong Provincial Hospital from January 2016 to December 2018,according to the different treatment,divided into ERAS scheme and traditional treatment group.Comparison of postoperative recovery diet time,postoperative exhaustion time,postoperative hospital stay,postoperative complications,and patient prognostic indicators between the two groups.Results:The 106 patients(mean age 63.68±8.99 years)were followed up to October 30,2019,and the mean follow-up time was 24.25±10.30 months.There were statistically significant differences in postoperative recovery time,postoperative hospitalization time and total hospitalization time between the ERAS group and the traditional group(P=0.017,P=0.022,P=0.003).There was no significant difference in postoperative complications between the two groups(P=0.218).COX univariate survival analysis showed that the factors affecting the survival time of patients were postoperative exhaust time(p=0.012,95%CI:1.086-1.938)and whether there were complications after operation(p=0.043,95%CI:1.036-8.907).Based on the univariate analysis results,after adjusting for gender,age,and BMI,COX multivariate analysis results suggest that the time of gastrointestinal recovering exhaust affects the patient's prognosis(P=0.012).Kaplan-Meier survival curves suggest that there is no statistically significant difference in prognosis for patients with enhanced recovery after surgery(Log rank P=0.76).Conclusion:enhanced recovery after surgery for patients with colorectal cancer and diabetes mellitus can accelerate postoperative recovery,reduce postoperative hospital stay and total hospital stay,and do not increase postoperative complications such as incision infection and pulmonary infection,and have no adverse effect on the prognosis of patients.Preoperative fasting blood glucose ?7.83mmol/L and exhaust time ?3.5 days were independent prognostic factors for colorectal cancer patients with diabetes.