| Objective:In the enhanced recovery after surgery(ERAS)system,the traditional high-dose,dual-frequency preoperative oral carbohydrate regimen can no longer meet the clinical needs of patients with colorectal cancer(CRC)because of the prolonged gap period in its use.Therefore,in this study,the safety and efficacy of a modified preoperative oral carbohydrate(POC)regimen was investigated in an accelerated recovery surgical system for colorectal cancer using a low-dose,multi-frequency regimen compared with a traditional high-dose,dual-frequency regimen.Through the implementation of this modified protocol,it is hoped that more CRC patients can benefit.Methods: In this study,50 patients who underwent elective CRC radical surgery at Yunnan Cancer Hospital from February 2022 to December 2022 were selected according to the nadir criteria in a randomized controlled trial and randomly divided into 25 patients each in the experimental and control groups.To ensure that the total dose of carbohydrates used in both groups was the same,patients who started surgery after 16:00 were selected for this study.A modified low-dose,multi-frequency POC protocol was used preoperatively in the experimental group,and a conventional high-dose,dual-frequency POC protocol was used preoperatively in the control group.The accelerated rehabilitation surgical protocol was performed in both groups,and the treatment protocols were the same except for the measures related to the intervention,and the subjective comfort scores of nausea and vomiting,thirst and hunger were compared between the two study groups at different time periods T0,T1,T2,T3 and T4 after the intervention was performed(T0: before the first carbohydrate intervention,T1: after the first carbohydrate intervention,T2: before the last carbohydrate intervention,T3: after the last carbohydrate intervention,T4: the first postoperative day),and changes in perioperative blood glucose and procalcitonin(PCT),and the occurrence of intraoperative reflux misaspiration and postoperative complications were recorded.Results: 1.There was no statistical difference between the baseline levels of the two study groups(P>0.05),and the two study groups were comparable.2.nausea and vomiting: the nausea and vomiting scores of the two study subjects at T0,T2,T3 and T4 were not statistically different(P > 0.05);the nausea and vomiting scores of the control group and the experimental group at T1 were statistically different(P < 0.05),and the nausea and vomiting scores of the experimental group were lower than those of the control group.The nausea and vomiting scores of the two study groups tended to increase after each carbohydrate administration and then decreased over time,with the change curve of the experimental group being flatter than that of the control group.3.Thirst: The thirst scores of the two groups were not statistically different at T0,T1,T3 and T4(P > 0.05),and the thirst scores of the control group and the experimental group were statistically different at T2(P < 0.05),and the thirst scores of the experimental group were lower than those of the control group;the thirst scores of the two groups showed an increasing trend over time,reaching the highest value at T2,and all of them decreased after the The change curve of the experimental group was more gentle than that of the control group.4.Hunger: The hunger scores of the two groups were not statistically different at T0,T1 and T4(P > 0.05);the hunger scores of the control group and the experimental group were statistically different at T2 and T3(P < 0.05),and the hunger scores of the experimental group were lower than those of the control group;the hunger scores of both groups showed an increasing trend over time,reaching the highest value at T2,and both showed a decreasing trend after the The change curve of the experimental group was more gentle than that of the control group,and the hunger scores of the experimental group were <3 points in the whole time period.5.Blood glucose: The blood glucose values of the two groups at the time of admission and before surgery were not statistically different(P > 0.05);the blood glucose values of the control group and the experimental group on the first day after surgery were statistically different(P < 0.05),and the blood glucose of the experimental group was lower than that of the control group;in the 72-hour postoperative dynamic blood glucose monitoring,the two groups did not show any difference in the long-term control of blood glucose(P>0.05).6.PCT: The PCT of the study subjects in the two groups at admission,on the third and fifth postoperative days was not statistically different(P>0.05),and the PCT of the control group and the experimental group at the first postoperative day was statistically different(P<0.05),and the PCT of the experimental group was lower than that of the control group;the PCT values of both groups decreased over time,and the PCT of the experimental group was lower than that of the control group,and the trend of PCT change in the experimental group The trend of PCT change in the experimental group was more gentle.7.Complications: No misaspiration of reflux occurred in both groups,and the remaining complications were not statistically different between the two groups(P >0.05).Conclusions: 1.The modified low-dose,multi-frequency POC regimen did not increase the risk of glycemic control and inflammation during hospitalization,nor did it increase the incidence of intraoperative reflux and misaspiration and postoperative complications in patients undergoing radical CRC surgery compared with the conventional regimen.2.The modified low-dose,multi-frequency POC regimen showed advantages in the ERAS system.Compared with the traditional high-dose,dual-frequency POC regimen,this regimen further reduced preoperative thirst,hunger,and nausea in patients undergoing radical CRC surgery,and showed advantages in short-term postoperative glycemic control and stress reduction.3.The modified low-dose,multi-frequency POC regimen can be safely applied in CRC radical surgery and effectively promote patients’ recovery. |
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