Effect of enhanced recovery after surgery applicated in patients undergoing gasroesophageal reflux disease operation

Abstract

Objective To explore the effect of accelerated rehabilitation strategy on gastrointestinal function recovery, pain and stress response factors in patiens with gasroesophageal reflux disease (GERD) treated by laparoscopic sugery. Methods Totally 62 cases of patients with GERD were selected for laparoscopic surgery from Septemper 2017 to June 2018 in the Xinjiang Uygur Automous Region People's Hospital. According to the stochastic numerical table method, all patients were divided into 2 groups, the accelerated rehabilitation group and the control group, with 31 cases in each group. The accelerated rehabilitation group was treated with enhanced recovery strategy in the perioperative period; the control group was treated with traditional anesthesia. The recovery time of gastrointestinal function (including bowel recovery time, anus exhaust time), postoperative pain visual simulation score (VAS), postoperative stress index [incuding C-reaction protein (CRP), cortisol level and white blood cell (WBC) count], postoperative activity time, hospital stay time, patients satisfaction, postoperative complication etc were recorded, and compared with t test. Results The time of anus exhaust, the bowel recovery time, postoperative activity time were shorter than those in control group, and the differences were statistically significant (t=14.95, 16.39, 14.94, all P<0.001). However, there was no statistically significant difference in hospital stay time and patients satisfaction scores. The scores postoperative pain VAS score was lower in the accelerated rehabilitation group than in control group, the difference was statistically significant (t=5.942, P< 0.001). In the control group, postoperative CRP level, WBC count were both higher than those before surgery, but the differences were not statistically significant. Cortisol level was also higher than that before surgery, but the difference was statistically significant (t=13.15, P=0.048). There were no statistically significant difference in CRP, cortisol level and WBC count before and after surgery between the two groups. CRP, cortisol level in the postoperative accelerated rehabilitation group were lower than those in the control group, and the difference were statistically significant (t=0.60, P=0.001; t=4.640, P<0.001). No serious complication occurred in the two groups. Conclusion In laparoscopic GERD operation at perioperative period, the application of accelerated rehabilitation strategy for anesthesia management can significantly promote the recovery of gastrointestinal function, alleviate postoperative pain, decrease the postoperative inflammatory response, and has higher security. Key words: Gasroesophageal reflux disease; Laparoscopy; Enhanced recovery after surgery; Anesthesia