Abstract
To explore the clinical effects of total laparoscopic radical gastrectomy under the guidance of the concept of enhanced recovery after surgery (ERAS). Fifty-five patients were perioperatively treated under the concept of ERAS (ERAS group), while the remaining 55 patients were treated under the traditional perioperative concept (control group). The operation time, intraoperative blood loss, the time of first anal exhaust and first postoperative off-bed activity, postoperative length of stay, and incidence of postoperative complications were recorded in both groups. The pain of patients was assessed using VAS system. The nausea and vomiting and abdominal distension were assessed using the NVDS and abdominal distension score, respectively, within 24 h after operation. The patient's daily living ability was evaluated by the ADL scale at 3 d after the operation. The time of first anal exhaust, the time of first postoperative off-bed activity time, and the postoperative in-hospital time were all significantly shorter in the ERAS group than those in the control group (P < 0.001). The VAS score in the ERAS group was significantly lower than that in the control group at 12 h, 24 h, 48 h, and 72 h after operation (P < .001). The ERAS group had significantly lower NVDS score and abdominal distension score than the control group (P < 0.001). The postoperative ADL score in the ERAS group was significantly higher than that in the control group (P < 0.001). ERAS during the perioperative period of total laparoscopic radical gastrectomy can promote the postoperative rehabilitation of patients and alleviate postoperative pain and gastrointestinal reactions, which is safe and effective.
Highlights
Gastric cancer, one of the most common malignancies, is the second major digestive tract malignancy in China, and its fatality rate ranks 3rd among malignancies [1, 2]
enhanced recovery after surgery (ERAS) reduces the physical and psychological traumatic stress of patients through optimizing a variety of perioperative treatments, thereby accelerating recovery. e benefits of ERAS lie in improving the therapeutic effect, reducing postoperative complications, accelerating the rehabilitation of patients and shortening the length of stay, lowering medical costs [8, 9]. e Guidelines for Enhanced Recovery After Gastrectomy was developed by the European Association of ERAS in July 2014, and the Chinese Expert Consensus on Enhanced Recovery After Surgery in Perioperative Management was issued by the Chinese Expert Group of ERAS in June 2016, which offered a basis to the use of ERAS concept in gastrectomy by clinicians [10]
Before the operation, varying degrees of stress response will occur in patients due to their fear of impending surgery, worry over adverse surgical effects, and panic about whether they can fully rehabilitate postoperatively, affecting the recovery of intestinal function
Summary
One of the most common malignancies, is the second major digestive tract malignancy in China, and its fatality rate ranks 3rd among malignancies [1, 2]. Chemoradiotherapy, molecular targeted drugs, and immunotherapy have gradually become mature, but surgery remains the rst-line treatment for gastric cancer, and laparoscopy has been increasingly applied in surgery [2–4]. Enhanced recovery after surgery (ERAS) was rst reported by a Danish surgeon Kehlet, and it was successfully applied in the elective surgery of colorectal tumor [5]. ERAS organically combining new techniques in anesthesiology, pain management, nutritional support, and surgery with improved traditional postoperative care aims to reduce or alleviate perioperative traumatic stress, promote postoperative recovery of intestinal function, facilitate postoperative rehabilitation, shorten length of stay, and lower medical expenses through multidisciplinary collaboration [6, 7]. The e ectiveness and safety of ERAS in total laparoscopic radical gastrectomy were assessed
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