Yanbing Zhou, Cheng Meng, Shougen Cao. Affiliated Hospital of Qingdao University
Objective: To investigate the clinical efficacy of enhanced recovery after surgery (ERAS) in the radical gastrectomy for gastric cancer.
Methods: A doubleblind, randomized, controlled study was performed in the 140 patients, and all of them were divided into the ERAS group and the control group based on a random number table. The inflammatory markers, nutritional index and postoperative recovery of patients were observed.
Results: The total protein in serum (TP), albumin (Alb), prealbumin, TNFα, IL-6, creactive protein, resting energy expenditure (REE), glycemic index, insulin index and Insulin resistance index in the 2 groups showed a range of variations at postoperative day 1, 3, and 5, and these were (61±5)g/L, (34±3)g/L, (160±18)g/L, (12.3±2.3)mmol/L, (101±34)ng/L, (43±11)g/L, (1 336±105)kal/d, (7.6±0.8)mmol/L, (16.8±3.5)mU/L and 5.7±1.3 in the ERAS group at postoperative day 1, and (58±4)g/L, (31±4)g/L, (147±18)g/L, (15.3±2.2)mmol/L, (122±37)ng/L, (56±27)g/L, (1 450±164)kal/d, (9.3±1.4)mmol/L, (30.5±6.8)mU/L and 12.5±3.2 in the control group, respectively, showing a significant difference between the 2 groups (F=31.63, 8.03, 67.36, 147.04, 9.63, 6.84, 16.10, 54.85, 104.51, 139.47, P<0.05). The duration of fever, time to flatus, duration of hospital stay, hospital expenses, numeric rating scale and quality of life (QOL) were (2.9±0.9)days, (2.9±0.6)days, (7.6±2.1)days, (28 495±4 722)yuan, 1.4±1.0 and 15.4±0.9 in the ERAS group after operation, and (3.8±0.6)days, (3.5±0.7)days, (8.9±2.6)days, (35 318±7 610)yuan, 2.4±1.1 and 14.4±1.2 in the control group, respectively, with a significant difference between the 2 groups (t=-0.91,-3.66,-2.85,-4.82,-4.20, 3.92, P<0.05). Two patients were complicated with respiratory diseases, 1 patient received reoperation and 1 was readmitted to the hospital at postoperative day 30 in the ERAS group. Three patients had respiratory diseases, 1 received reoperation and 2 were readmitted to the hospital at postoperative day 30 in the control group, with no significant difference between the 2 groups (P>0.05).
Conclusions: ERAS is safe and feasible for the perioperative treatment of patients with gastric cancer, meanwhile it could reduce the surgical stress, shorten the duration of hospital stay and improve QOL and postoperative complications.
Keywords: ERAS, Surgical Stress, postoperative complications