Application And Comparison Of Postoperative Complications Of Enhanced Recovery After Surgery In Distal Gastric Cancer Patients With Different Degrees Of Malnutrition

Background: Gastric cancer is one of the most common malignant tumors in humans.More than 70% of new cases of gastric cancer occur in developing countries.About 50% of cases occur in eastern Asia,mainly in China.Patients with gastric cancer are often accompanied by decreased appetite,poor digestion and absorption,etc,and coupled with the high decomposition,high metabolism,and low synthesis of metabolic disorders brought about by the tumor,there will be varying degrees of malnutrition.Surgery is currently an effective treatment for gastric cancer.In recent years,enhanced recovery after surgery(ERAS)has gradually been applied to the surgical field,and it has reduced the psychological and physiological stress by integrating a series of optimized perioperative management measures,including anesthesia control,minimally invasive concept,perioperative nursing intervention,etc.to avoid postoperative complications,shorten the hospital stay,and accelerate postoperative recovery.However,the application of ERAS needs to be organically combined with the specificity of individual patients.Objective: Our aim is to analyze and compare the general clinical data an d postoperative complications of different degrees of malnutrition in patients with distal gastric cancer through the application of the en hanced recovery after surgery(ERAS)concept,and to further guid ance on surgical safety and perioperative management.Methods: In this paper,we retrospectively analyzed 162 patients with distal gastric cancer in the second surgery group of the Department of Gastric Colorectal Surgery of the First Hospital of Jilin University from July 2015 to July 2017.We applied NRS2002,PG-SGA,and laboratory tests to evaluate the nutritional risk and malnutrition status of patients.All patients with no,suspicious,moderate malnutrition,and a part of patients with severe malnutrition were treated with the concept of ERAS for perioperative management.And the remaining part of patients with severe malnutrition using traditional perioperative management plan.Comparing and analyzing the basic clinical data,complications,length of hospital stay,various laboratory tests,etc.Results: 1、The proportions of distal gastric cancer patients with malnut rition in no,suspicious,moderate,and severe malnutrition were 21%,12%,36%,and 31%.2、Patients with no,suspicious,moderately malnourished distal gastric cancer are managed by ERAS concep t,the incidence of postoperative complications was not statistically different from that of other institutions.3、The postoperative hospita l stay and postoperative complication rate in patients with severe m alnutrition were higher than those with no,suspicious and moderate malnutrition,and the difference was statistically significant.4、In p atients with severe malnutrition,the length of hospital stay in the E RAS group was higher than that in the nutritional support group,a nd the difference was statistically significant.The difference value of Prealbumin and Retinol-Binding Protein in ERAS group was lo wer than that in nutritional support group,and the difference was s tatistically significant.Conclusion: Severe malnutrition is a risk factor to increase postoperative co mplications;As for distal gastric cancer patients with no,suspicious,moderate malnutrition,the perioperative management of ERAS is safe and effective;As for distal gastric cancer patients with severe malnutrition,Preoperative good nutritional support will shorten posto perative hospital stay and speed up recovery of nutritional status.