| BackgroundAs one of the third malignant tumors in our country,gastric cancer has been a great burden to our health and economy.It is estimated that there are more than 400,000 new cases and 300,000 deaths every year,accounting for about 15% of the total cancer deaths and 3% of the total deaths[1][2].Today,China has become an aging country,and the proportion of the elderly increased year by year?Thus,a variety of diseases and their burden will follow.The general physical condition,physiological state and immune function of the elderly patients are different from those of the young people.FTS(fast-track surgery)was first proposed by the Danish physician.Gradually,clinical trials and research are being carried in domestic and abroad.As a hot spot in recent years,optimizing perioperative intervention measures,reducing disturbance to the patient's internal environment could accelerate postoperative recovery.Since the application of laparoscopic technique in the gastrointestinal surgery in the 90 s of last century,after the development and improvement,laparoscopic radical gastrectomy for gastric cancer has been achieved.In view of the difference between elderly patients with gastric cancer,the concept of rapid rehabilitation surgery can not be copied from past experience.This article will start the research and discussion.ObjectiveThe aim is to apply FTS to elderly patients undergoing laparoscopic radical gastrectomy,to investigate the short-term effect and inflammatory reaction after operation.MethodFrom October 2014 to October 2016 at the gastrointestinal surgery in people's Hospital of Zhengzhou University,92 elderly patients undergoing laparoscopic radical gastrectomy were selected,which included 46 patients with fast-track surgery(observation group),a total of 46 patients with conventional treatment(control group).A retrospective analysis of the clinical data and biochemical examination results were compared between the two groups,including C reactive protein(C reactive protein,CRP),procalcitonin(procalcitonin,PCT),the average hospitalization and the venting time of postoperative anal.SPSS 24 was used for statistical analysis.ResultsCRP and PCT of Patients in two groups were higher than before,the control group increased significantly(P<0.05).After the first,4th,and 7th day,CRP of the observation group was:17.19±11.14(mg/L),13.81±4.17(mg/L),6.98±1.98(mg/L),while CRP of the control group was:24.91±17.88(mg/L),19.91±7.79(mg/L),8.70±1.84(mg/L).After the first,4th,and 7th day,PCT of the observation group was:1.59±1.29ng/mL,1.41 ± 1.16ng/mL,0.59 ± 0.40ng/mL,while PCT of the control group was:2.30 ± 1.20ng/mL,1.87 ± 1.24ng/mL,0.71 ± 0.42ng/mL.The postoperative ventilation time in the observation group was 50.38±10.83 h,while 69.86±14.72 h in the control group.The average length of stay in the observation group was 9.10±2.53 d,while 11.05±2.94 d in the control group.The difference was statistically significant.There were 5 cases of postoperative complications in the observation group,the incidence rate was 10.87%.There were 7 cases of complications in the control group,and the incidence rate was 15.22%.All the complications were cured after conservative treatment.The difference of complications was not statistically significant(P > 0.05).ConclusionFor elderly patients undergoing laparoscopic radical gastrectomy,perioperative rehabilitation under the guidance of the concept of fast-track surgery can achieve satisfactory clinical results. |
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