Application Of Preconditioning Training In Perioperative Period Of Laparoscopic Colorectal Cancer Patients

Objective:Preconditioning training means that patients adapt to the postoperative training content based on the concept of enhanced recovery after surgery(ERAS)in advance before operation,so as to improve patients’compliance on postoperative training based on ERAS concept,so as to accelerate the postoperative rehabilitation of patients.To explore the effect of preconditioning training on postoperative recovery of laparoscopic colorectal cancer patients,preconditioning training was performed on patients undergoing laparoscopic colorectal cancer surgery.Method:This is a randomized controlled trial involving patients with colorectal tumor diagnosed by CT and with colorectal cancer diagnosed by colonoscopy as well as scheduled for laparoscopic radical resection of colorectal cancer from November 2021 to August 2022.The patients were randomly divided into experimental group(n=60)and control group(n=60).The control group received routine ERAS during perioperative period,while the trial group received preoperative preconditioning training on the basis of perioperative management in the control group.The intervention time was the waiting time before operation,about 7 days.The main observation indicators were the compliance of postoperative training,the incidence of postoperative complications and postoperative hospital stay.The secondary observation indexes were the first postoperative exhaust and defecation time,the first postoperative eating time,the first time to get out of bed after operation,perioperative 6-minute walking distance(6WMD),perioperative nutritional indicators(albumin,total protein,hemoglobin).After data collection,IBM SPSS Statistics 26.0 and R language Scheirer-Ray-Hare package were used to analyze.Result:A total of 127 patients were included in this study.Through the inclusion and exclusion criteria,a total of 73 patients completed the trial(trial group=37,control group=36).There was no significant difference in sex composition,age,education level,proportion of intestinal obstruction,preoperative Nutritional Risk Screening 2002(NRS2002),preoperative disease,preoperative nutritional indicators(albumin,total protein,hemoglobin),tumor location,tumor stage and tumor differentiation,proportion of lymph node metastasis,operation time,operative blood loss,sample extraction,hyperthermic intraperitoneal chemotherapy(HIPEC)between the two groups(P>0.05).The compliance on postoperative training in the trial group was significantly higher than that in the control group(H=64.766,P<0.05).The incidence of postoperative complications in the test group(18.9%)was lower than that in the control group(44.4%),and the difference was statistically significant(~2=5.509,P=0.019).The severity of postoperative complications in the test group was lower than that in the control group,and the difference was statistically significant(~2=5.880,P=0.036).The postoperative hospital stay in the trial group[7.00(6.00,8.00)d]was shorter than that in the control group[9.00(7.00,11.00)d],and the difference was statistically significant(Z=2.633,P=0.008).The time of first exhaust and defecation after operation in the trial group[26.96(21.65,44.49)h,47.00(36.00,63.77)h]was shorter than that in the control group[43.62(35.97,53.61)h、59.50(52.00,73.00)h],and the difference was statistically significant[(Z=-3.889 P<0.001),(Z=-3.306,P=0.001)].The first time to get out of bed after operation in the trial group[19.00(18.00,26.00)h]was shorter than that in the control group[26.00(22.00,32.75)h],and the difference was statistically significant(Z=-3.308 P=0.001).The activity rate of the trial group within 24 hours after operation(73%)was higher than that of the control group(41.7%),and the difference was statistically significant(~2=7.319,P=0.007).The postoperative 6-minute walking distance of the trial group was significantly higher than that of the control group(F=43.977,P<0.05),and the perioperative albumin and total protein levels of the trial group were significantly higher than those of the control group(F=4.877,P<0.005,F=5.952,P<0.005),but there was no significant difference in perioperative hemoglobin level between two group(F=2.134,P>0.005).There was no significant difference in the time of first feeding between the trial group and the control group after operation(Z=-1.580,P=0.114).Conclusion:Preconditioning training can improve the compliance of laparoscopic colorectal cancer patients with postoperative training,promote the recovery of gastrointestinal function,shorten the time of getting out of bed,improve the functional status of patients,improve the nutritional level of patients,reduce the incidence of postoperative complications,reduce the severity of postoperative complications and shorten the time of hospitalization after operation,it is an alternative preoperative management strategy.