The Influence Of Fast-track Surgery On Laparoscopic Surgery On Patients With Colorectal Cancer With Stress Reactions

Research on fast track surgery by Denmark's abdominal surgery doctor Henrik Kehlet put forward in the late 1990 s,it is confirmed to have confirmation medicine,a series of optimization in the application in the perioperative treatment,to reduce the physical and psychological stress due to surgery,reduce the incidence of complications related to the operation,the postoperative recovery time shortened,so as to achieve the purpose of rapid rehabilitation,and can reduce the medical cost,save medical resources.Fast-track surgery at the heart of the target is to reduce perioperative psychological and physiological stress reaction,reduce the incidence of postoperative complications,patients in order to achieve rapid recovery.Laparoscopic surgery with small trauma,to reduce the incidence of complications,the characteristics of postoperative recovery fast,it has the same goal with rapid rehabilitation surgery.Objective:Analysis and compare in perioperative period of fast track sugery and traditional pattern in laparoscopic colorectal surgery and radical impact on patients' stress reaction,discusses the application of perioperative period the advantages of fast-track surgery concept.Methods:Collection in November 2015 to January 2017 gastrointestinal anus colorectal surgery patients undergoing laparoscopic colon,rectal cancer,radical,conform to the standards of a total of 97 cases of patients,which received perioperative patients with fast track mode as the experimental group,a total of 47 cases.Perioperative lines of the traditional mode of treatment for the control group,a total of 50 cases.Compare and analyze the indicators should be recorded in this study.In this study the indicators are as follows:1,general indicators: gender,age,body mass index,tumor size and location,and TNM staging.2,stress indicators: preoperative and on the 1st,3st,5st day after sugery of C-reactive protein(CRP)and white blood cells(WBC),interleukin 6(IL-6),concentration of serum amyloid A(SAA).3,postoperative rehabilitation indicators: exhaust time,postoperative hospitalization days,hospitalization expenses,the postoperative complications.Results:1,Two groups of patients in gender,age,body mass index,tumor size and location,TNM staging are comparable,(P > 0.05).2,Stress index contrast:The CRP concentration changes: the experimental group comparedwith control group,the level of CRP on preoperative was [(4.08±1.13)mg/L vs.(3.90±1.18)mg/L,t=0.766,P=0.446],there is no statistical significance.On the 1st day after sugery,the level of CRP was[(33.65±8.65)mg/L vs.(44.43±9.04)mg/L,t=18.091,P<0.001];On the3 st day after sugery,the level of CRP was [(75.92±12.49)mg/L vs.(103.08±17.04)mg/L,t=8.990,P<0.001];On the 5st day after sugery,the level of CRP was [(54.85±10.43)mg/L vs.(62.40±13.67)mg/L,t=3.069,P=0.003].The WBC count changes: the experimental group compared with control group,the level of WBC on preoperative was [(5.97±1.70)×109/L vs.(6.01±1.34)×109/L,t=0.129,P=0.898],there is no statistical significance.On the 1st day after sugery,the level of WBC was[(12.84±1.13)×109/Lvs.(15.58±1.28)×109/L,t=11.149,P<0.001];On the 3st day after sugery,the level of WBC was [(7.98±1.24)×109/Lvs.(9.35±1.32)×109/L,t=5.26,P<0.001];On the 5st day after sugery,the level of WBC was [(6.44±2.17)×109/L vs.(7.71±1.88)×109/L t=3.086,P=0.003].IL-6 concentration changes: the experimental group compared with control group,the level of IL-6 on preoperative was [(4.2±1.3)pg/ml vs.(4.0±1.2)pg/ml,t=0.788,P=0.433],there is no statistical significance.On the 1st day after sugery,the level of IL-6 was [(117.7±9.5)pg/ml vs.(141.0±6.2)pg/ml,t=14.209,P<0.001];On the 3st day after sugery,thelevel of IL-6 was [(82.4±10.6)pg/ml vs.(106.7±16.0)pg/ml,t=8.867,P<0.001];On the 5st day after sugery,the level of IL-6 was [(82.4±10.6)pg/ml vs.(106.7±16.0)pg/ml,t=8.867,P<0.001].SAA concentration changes: the experimental group compared with control group,the level of SAA on preoperative was [(3.49±1.33)mg/L vs.(3.82±1.92)mg/L,t=0.989,P=0.325],there is no statistical significance.On the 1st day after sugery,,the level of SAA was[(105.67±12.12)mg/L vs.(115.82±8.75)mg/L,t=4.704,P<0.001];On the3 st day after sugery,,the level of SAA was [(69.42±8.45)mg/L vs.(91.43±2.23)mg/L,t=15.312,P<0.001];On the 5st day after sugery,,the level of SAA was [(33.61±7.73)mg/L vs.(46.93±5.10)mg/L,t=9.952,P<0.001].Compared two groups of patients in postoperative days 1,3,5 in the levels change on C-reactive protein(CRP),white blood cells(WBC),interleukin 6(IL-6),and serum amyloid A(SAA),the decline in the experimental group were larger than the control group(P < 0.05).3,postoperative recovery index contrast: the experimental group compared with control group,the fast recovery of intestinal function[(61.6±6.2)h vs.(71.8±3.3)h,t=10.023,P<0.001],and shorter hospitalization time [(8.43±1.50)d vs.(11.45±2.02)d,t=8.393,P<0.001],hospitalization expenses low[(4.7±1.5)million yuan vs.(5.6±1.3)million yuan,t=3.163,P<0.05].Two groups of postoperative complications,nostatistical significance(10.64% vs.16.0%,?2=0.888,P=0.828)Conclusion:1.Fast track sugery joint laparoscopic surgery can reduce postoperative patients with colorectal cancer radical stress reaction2.Compared with traditional perioperative treatment,speed up the patients with postoperative rehabilitation,shorten the hospitalization days and reduce the hospitalization expense3.Compared with the traditional processing mode,patients with fast track surgery does not increase the incidence of postoperative complications4.Fast track sugery joint laparoscopic surgical treatment of colorectal cancer obvious advantages,having good and extensive application prospect and is worth promoting.