The Postoperative Effects Of Preoperative Enhanced Recovery After Surgery In Laparoscopic Colorectal Tumor Surgery

Objective To investigate the safety and effectiveness of preoperative management of enhanced recovery after surgery(ERAS)in laparoscopic colorectal cancer surgery.Method.Methods Eighty-six patients who underwent laparoscopic radical resection of colorectal cancer in the general surgery department of Fuyang People's Hospital from 2016 to2018 were selected,and the operation was performed by the same group of surgeons.Eighty-six patients were randomly divided into two groups according to random number method,43 patients were treated with preoperative measures of enhanced recovery after surgery(ERAS group),and 43 patients were treated with traditional preoperative measures of perioperative surgery(traditional group).In ERAS group,routine preoperative education,mechanical enema was not routinely performed before operation,and patients with intestinal dysfunction were enema with polyethylene glycol electrolyte powder before operation;200 ml of sugar water was orally taken 2 or 3 hours before operation,and solid food was fasted 6 hours before operation;gastric tube was not routinely placed before operation.Preoperative education was not routine in the traditional group;mechanical enema and 500 ml warm soapy water enema were routinely performed before operation to observe the defecation of patients.If there was still fecal residue in the stool,500 ml warm soapy water enema was given again;drinking water was prohibited 8 hours before operation,and diet was prohibited 12 hours before operation;gastric tube was routinely indwelled in the morning of operation.The two groups of patients had the same intraoperative and postoperative management measures.General data(age,sex,surgical method,preoperative hemoglobin,preoperative albumin),clinical indicators(time to recover diet,time to remove drainage tube after surgery,length of hospital stay after surgery,albumin content after operation),complications(incision infection,abdominal infection,pulmonary infection,intestinal obstruction,anastomotic leakage,deep vein thrombosis)were analyzed.Results1.There were no significant differences in general data including age,sex,operation method,preoperative albumin and preoperative hemoglobin between the two groups(P > 0.05).2.The time of drainage tube removal in ERAS group(7.28 2.38 days)was shorter than that in traditional group(9.47 4.67 days)(P < 0.05);the time of resuming diet after operation in ERAS group(3.09 2.74 days)was shorter than that in traditional group(4.88 3.94 days)(P < 0.05);The postoperative hospital stay in the ERAS group(9.56 +3.14 days)was shorter than that in the traditional group(13.58 + 4.69 days)(P <0.05).The serum albumin(39.67 ± 5.43 g / L)of ERAS group was higher than that of traditional group(36.71 ± 4.80 g / L)(P < 0.05).3.In terms of postoperative complications,the incidence of pneumonia in the ERAS group was less than that in the traditional group(P < 0.05);there was no significant difference between the two groups in terms of intestinal fistula,postoperative deep vein thrombosis and incision infection(P > 0.05).Conclusion Preoperative treatment measures of accelerated rehabilitation surgery are safe and effective in laparoscopic colorectal tumor surgery,which can reduce stress response,accelerate postoperative recovery,shorten the length of stay of patients,and do not increase surgical complications.