| In recent years,with the change of life style,the incidence of colorectal cancer in China is increasing,and surgery is still the most important treatment for colorectal cancer.The concept of enhanced recovery after surgery(ERAS)is gradually introduced into clinical practice and deepening,including aspects like preoperation education,minimally invasive surgery,multimode analgesia,restrictive liquid treatment,early feeding,early activity,optimizing nursing.Evidence-based elements of ERAS in perioperative period are arranged reasonably in order to reduce surgical trauma,minimize the stress response before and after surgery,reduce the incidence of postoperative complications.So we can speed up the recovery process and achieve the purpose of reducing medical expenditure.In recent thirty years,laparoscopic colorectal surgery has been widely applied in clinic.There are researches that have confirmed the feasibility and safety of laparoscopic surgery in the treatment of colorectal malignancies.Objective:This paper compares the indicators of laparoscopic colorectal cancer patients with enhanced recovery after surgery and traditional perioperative care.So that we can analyze the efficiency of ERAS programme for colorectal surgery.Methods:This study includes cases who had been diagnosed with colorectal cancer and underwent radical surgical treatment in our hospital during October 2015 and May 2017.All the cases met the inclusion criteria and were randomly divided into the traditional group and ERAS group by the random number table.The two groups were all operated surgeries in a laparoscopic way.The ERAS group received preoperative rehabilitation,analgesia management,gastrointestinal decompression avoidance,early postoperative oral feeding,postoperative early mobilization and other measures of ERAS programme.The traditional group was managed in a traditional way.A total of112 cases were included in this study after excluding the cases which accord with the exclusion criteria.Among them,66 were male,46 were female,28 cases were diagnosed with colon cancer,and 84 cases were rectal cancer.The similarities and differences of the perioperative indexes were collected and analyzed between the two groups.The specific indicators are as follows:General situation: Gender,age,BMI,tumor diagnosis,tumor stagingLaboratory indexes: preoperative serum albumin(ALB),white blood cell count(WBC)of the day before operation,WBC of the operation day and 1,3,5 days after operationSurgical related indexes: operation mode,operation time Recovery index: postoperative exhaust time,postoperative defecation time,oral feeding time,postoperative hospital days,total hospitalization,hospitalization expensesPostoperative adverse reactions and complications:pharynx discomfort,nausea and vomiting,abdominal distention,intestinal obstruction,urinary retention,urinary infection,incision infection,pulmonary infectionResults:The sex ratio(χ2=0.3728,P=0.5415),age(t=0.3889,P=0.6981),BMI index(t=0.3043,P=0.7615),Tumor location(χ2=0.5835,P=0.4449)and operation time(t=1.067,P=0.2883)showed no significant difference between the two groups of patients.The patients in the traditional group were hospitalized 11.79 + 0.5651 days after operation,and the patients in the ERAS group were hospitalized 10.35 + 0.4178 days after operation,t=2.043,p=0.0434.The traditional group semi liquid diet time was 6.140 + 0.2642 days after surgery and ERAS group was 3.527 + 0.2057 days,t=7.766,p<0.0001.The first post operative exhaust of the traditional group happened 4.526 +0.2428 days after surgery,and the ERAS group only took 3.636+ 0.2480 days,t=2.564,p=0.0117.The first defecation time of the traditional group was 6.211 + 0.3328 days,and the ERAS group first defecation time was 4.873 + 0.2660 days,t=3.127,p=0.0023.The differences were statistically significant.There was no significant difference in the number of total hospitalization days and hospitalization expenses.Neither the serum albumin level(ALB)nor the white blood cell count(WBC)has significant difference between the two groups before operation.WBC of 1,3,5 days after surgery in the traditional group was significantly higher than that in the ERAS group.There were 33 times of adverse reaction in the traditional group and 15 times in the ERAS group.statistically Significant difference was found in occurrence of pharynx discomfort of two groups(χ2=13.29,p=0.0003).Two groups’ complication rate had no significant difference.Conclusion:ERAS is safe and effective for patients with laparoscopic colorectal cancer.ERAS can accelerate the recovery of gastrointestinal function. |
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