| The effect of enhanced recovery after surgery on the stress index of patients undergoing radical resection of rectal cancerBackground:Colorectal cancer is the most common malignancy of the digestive tract.In recent years,the morbidity and mortality of colorectal cancer in China are increasing gradually.The application of ERAS in colorectal cancer surgery has been recognized internationally.Research on ERAS in China has also achieved good results.However,there are few reports on the role of ERAS in colorectal cancer from the perspective of perioperative stress indicators.Objective: To investigate the effects of ERAS technique on stress indexes in patients undergoing laparoscopic rectal cancer surgery.Methods: One hundred and twenty patients,underwent laparoscopic rectal cancer surgery(Dixon or Miles)in Xinqiao Hospital of the Army Medical University,were included in this study and then were randomly divided into an ERAS group(n=60)and a conventional treatment group(n=60).The ERAS group was treated by ERAS technique during perioperative period.The conventional treatment group was treated with traditional treatment concept during perioperative period.White blood cell count(WBC),C-reactive protein(CRP)and interleukin-6(IL-6)were compared at the time of admission,1 h before surgery,24 h after surgery,48 h after surgery and 72 h after surgery.The first postoperative anal exhaust time,the first postoperative defecation time,and the total hospitalization time were also recorded after operation.Results:(1)There were no statistically significant difference between the two groups in gender,age,tumor size and tumor TNM stage(P>0.05).(2)There were no significant differences in WBC and CRP and IL-6 levels at admission and l h before operation between the conventional treatment group and the ERAS group(P>0.05).The levels of CRP and IL-6 and WBC in the ERAS group were significantly lower than those in the conventional treatment group at 24 h,48 h and 72 h after operation(P<0.05).(3)The postoperative first anal exhaust time,postoperative first defecation time and total hospital stay of ERAS group were significantly shorter than those of the traditional treatment group(P<0.05).Conclusion: ERAS techniques can reduce the stress response of patients undergoing laparoscopic radical resection of rectal cancer,reduce its complications and promote early recovery.Analysis of postoperative stress index and short-term efficacy of laparoscopic radical gastrectomy with single hole plus one hole(SILS+1)in patients with enhanced recovery after surgeryBackground: Gastric cancer is one of the most common gastrointestinal tumors.In recent years,the morbidity and mortality of gastric cancer have been increasing,ranking the second among malignant tumors in China.Enhanced recovery after surgery is still the most effective treatment for gastric cancer.In recent years,with the increasingly development of gastric cancer surgery research,as well as the continuous development and application of minimally invasive surgery,the transumbilical single-hole laparoscopic technique SILS has become a hotspot in the development of laparoscopic technology in recent years,while the single-hole or single-hole plus one-hole laparoscopic treatment of gastric cancer has been rarely reported.The clinical application of transumbilical single hole plus one hole(SILS+1)laparoscopy lacks evidence-based medical evidence.Objective: To compare the short-term efficacy and stress index of single hole plus one hole(SILS+1)laparoscopy and traditional five-hole laparoscopy under ERAS in patients undergoing radical gastrectomy for gastric cancer.Methods: One hundred and fourteen patients underwent laparoscopic radical gastrectomy surgery in Xinqiao Hospital of the Army Medical University were included in this study.Then they were randomly divided into SILS+1 group(n=66)and conventional laparoscopic group(n=48).Patients in both groups were treated in perioperative period according to the concept of ERAS.Patients in the SILS+1 group were operated with the single-incision concept,while those in the traditional laparoscopic group were operated with the traditional five-hole laparoscopic method.People court record and compare the 2 groups of patients,1 day preoperative,postoperative 1 day,3 days and 5 days after stress index of the WBC,CRP,IL-6,blood sedimentation(erythrocyte sedimentation rate,the ESR)and calcitonin(procalcitonin,PCT)levels,compared two groups of patients with operation time,incision length,intraoperative blood loss,tumor TNM staging,The time of postoperative gastric tube removal,the time of first feeding,the time of first getting out of bed,the time of first anal exhaust,the time of first defecation and the time of postoperative hospital stay also were recorded.Results:(1)The age,gender,Body Mass Index(BMI),tumor diameter,and TNM stage had no significant differences(P>0.05).(2)The SILS+1 group had significantly longer duration of laparoscopic surgery than the traditional five-hole laparoscopic group(P<0.05).(3)The levels of WBC,CRP,ESR,PCT and IL-6 in the SILS+1 group were significantly lower than those in the traditional five-hole laparoscopic group at 1 day,3 days and 5 days after operation(P<0.05).(4)The operation time,incision length,the first postoperative anal exhaust time,the first postoperative defecation time,and the total hospitalization time in SILS+1 group were significantly shorter than those in the cconventional laparoscopic group(P<0.05).Conclusion: Under ERAS concept,SILS+1 can prolong the operation time compared with the traditional five-port laparoscope,but it can obtain better short-term clinical efficacy.In addition,SILS+1 is helpful to reduce the stress response of patients after radical gastritis and promote the early recovery of patients after surgery. |
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