Clinical Research Of Enhanced Recovery After Surgery(ERAS) In Preioperative Period Of Laparoscopic Panhysterectomy

Objective:To investigate the value of clinical research on the concept of ERAS in the perioperative period of laparoscopic Panhysterectomy patients,and to study its impact on the postoperative recovery of patients and clinical application value.Methods:The general data of patients diagnosed with uterine fibroids between September2020 and November 2022 at Jiangsu Subei People’s Hospital were selected,and all patients underwent laparoscopic total hysterectomy under elective surgery.After screening by inclusion and exclusion criteria,a total of 402 eligible cases,aged between 37 and 60 years,were identified.Patients in the ERAS group were treated according to the perioperative management method of enhanced recovery after surgery with evidence-based medicine,and patients in the conventional group followed the conventional perioperative management.The surgical patients were randomly divided into two groups:201 patients in the ERAS group;201 patients in the conventional group.All patients were approved by the medical ethics committee of Subei People’s Hospital,preoperative and signed informed consent forms and randomized groups.The general data(body mass index,age),preoperative thirst and hunger,intraoperative bleeding,length of surgery,time to first feeding,time to return to general feeding,time to first defecation,time to defecation and time to get out of bed,postoperative 24 h pain VAS score,total hospitalization time,hospitalization cost,incidence of total postoperative complications and satisfaction with the visit were compared between the two groups.Results:There was no statistical difference in body mass index and age between the ERAS group and the conventional group(P>0.05).The incidence of preoperative thirst and hunger was 48.75%(98/201)in the ERAS group and 22.40%(45/201)in the conventional group.Patients in the ERAS group had a lower incidence of preoperative thirst and hunger than in the conventional group,with a statistical difference between the two groups(P<0.05).There was no statistically significant difference in the total operative time and intraoperative blood between the ERAS group and the conventional group(P > 0.05).However,the first postoperative anal venting time was 23.15±4.146 h in the ERAS group and 26.75±4.511 h in the conventional group;the first postoperative bed time was 17.74±1.204 h in the ERAS group and 19.95±1.611 h in the conventional group;the length of postoperative hospitalization was 4.850±0.445 days in the ERAS group and5.626±0.246 days in the conventional group.The time to first anal discharge and the total length of postoperative hospitalization were significantly shorter in the ERAS group;the postoperative recovery indexes,such as anal discharge,time to first bed activity and total length of postoperative hospitalization,were smaller in the ERAS group than in the traditional group,and the difference was statistically significant(P<0.05).The average postoperative abdominal drainage volume in the ERAS group was54.05±7.672 ml,and the average drainage volume in the traditional group was 54.64±8.072 ml.There was no significant difference in drainage volume between the ERAS group and the conventional group(P>0.05).The time to first feeding,resumption of general feeding and first defecation in the ERAS group was 18.47±1.423 h,49.91±1.448 h and 26.44±2.641 h,respectively.Compared with the conventional group,the time of first feeding,resumption of general feeding and first defecation in the ERAS group was smaller than that in the conventional group,and the difference was statistically significant(P<0.05).The average hospitalization cost of patients in the ERAS group was 13806.78±717.00 yuan and in the conventional group was15501.49±1359.31yuan;the average hospitalization cost of the ERAS group was lower than that of the conventional group,and the difference was statistically significant(P<0.05).In addition,the incidence of total postoperative complications in the ERAS group was significantly less than that in the control group,and the differences were statistically significant in both groups(P<0.05).Conclusion:The development of ERAS in complete hysterectomy is effective and feasible and is worth promoting in gynecological surgery.It shortens the number of days of hospitalization and saves hospitalization cost to a certain extent;reduces the postoperative pain of patients while significantly improving their postoperative quality of life and facilitating their postoperative recovery.