Enhanced Recovery After Surgery For Preoperative Malnutrition In Patients With Colorectal Cancer

Objective:.Through preoperative malnutrition screening,patients with moderate to severe malnutrition with colorectal cancer were treated with accelerated rehabilitation surgery after nutritional therapy,and to explore the feasibility and safety of ERAS in colorectal cancer patients with preoperative severe malnutrition.Methods:In this study,we select colorectal cancer patients admitted to the hospital from January 2015 to January 2017.Preoperative nutritional is assessed to the patients with colorectal cancer in our department through the PG-SGA.Select the score more than 4 cent in 59 patients with severe malnutrition,nutritional therapy for 7-10 days,according to the wishes of patients and exclusion criteria included enhanced recovery after surgery model(ERAS group)21 cases,conventional surgical mode(conventional group)32cases.Analysis of ERAS group and traditional group in the perioperative serum albumin level,operation time,intraoperative bleeding,anal exhaust time,postoperative nausea and vomiting,incision infection,pulmonary infection,anastomotic leakage and postoperative hospitalization time and cost of the differences between.Results:There is no significant difference in serum albumin level between the ERAS group and the traditional group at 1 days before operation and seventh days after the operation(P>0.05),Fourth days after operation,ERAS group is significantly higher than that of the traditional group(P<0.05),traditional serum albumin water on the fourth day after operation decreased seventh days after operation,there were significant differences in the changes of perioperative period(P<0.05),while the ERAS group change in perioperative period was no obvious statistical difference(P>0.05).There is no statistical difference between the ERAS group and the traditional group in the time of operation and the amount of bleeding during operation.The anal exhaust time of group ERAS is significantly earlier than that of the traditional group,and the number of nausea and vomiting was significantly lower than that of the traditional group,and there is a statistically significant difference in anal exhaust time and nausea and vomiting between the two groups(P<0.05).There is 1 case of postoperative incision infection,2 cases of pulmonary infection and 0 case of anastomotic fistula in the ERAS group.There are 2cases of incision infection,3 cases of pulmonary infection,1 case of anastomotic fistula in the traditional group,No statistically significant(P>0.05).The hospitalization time of group ERAS is significantly lower than that of the traditional group,the hospitalization expense is significantly lower than that of the traditional group,and there is a statistically significant difference between the two groups in postoperative hospital stay and hospitalization expenses(P<0.05).Conclusion:Moderate to severe malnutrition in patients with colorectal cancer,after preoperative nutritional treatment,enhanced recovery after surgery mode do not increase incision infection,pulmonary infection and the incidence of anastomotic fistula,and can make the serum protein stability after operation;the time of anal exsufflation;postoperative vomiting decreased heart evil probability;shorten the hospitalization time of hospitalization;to reduce costs,it is safe and feasible,...