Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan.
Gastric Cancer. 2012 Jan;15(1):34-41. doi: 10.1007/s10120-011-0057-x. Epub 2011 May 15.
Radical gastrectomy for gastric cancer is among the most invasive procedures in gastrointestinal surgery. Several studies have found that an enhanced recovery after surgery (ERAS) protocol is useful in patients who undergo colorectal surgery, but its value in gastric surgery remains uncertain. The aim of this study was to assess the usefulness of an ERAS protocol for gastric surgery.
We studied the clinical characteristics, oncological factors, surgical factors, and outcomes in patients who underwent elective radical gastrectomy for gastric cancer before and after the introduction of an ERAS protocol.
The first days of oral intake, oral intake recovery, flatus, and defecation were significantly earlier in the ERAS group (n = 91) than in the conventional care (CONV) group (n = 100). Maximum pain evaluated on a visual analog scale and the number of additional analgesics on demand were significantly less in the ERAS group than in the CONV group. The ratio of the postoperative body weight at 1 week to the preoperative body weight was significantly higher in the ERAS group than in the CONV group (0.95 vs. 0.94, respectively, P = 0.01).
Our results suggest that the ERAS protocol is useful in patients who undergo elective radical gastrectomy.
胃癌根治术是胃肠道外科中最具侵袭性的手术之一。多项研究发现，加速康复外科（ERAS）方案在结直肠手术患者中是有效的，但在胃癌手术中的价值仍不确定。本研究旨在评估 ERAS 方案在胃癌手术中的应用价值。
我们研究了在引入 ERAS 方案前后接受择期胃癌根治术患者的临床特征、肿瘤学因素、手术因素和结局。
ERAS 组（n=91）患者的首次口服摄入时间、口服摄入恢复时间、排气和排便时间均明显早于常规护理（CONV）组（n=100）。ERAS 组患者的视觉模拟评分最高疼痛和按需使用额外镇痛药的次数明显少于 CONV 组。ERAS 组患者术后第 1 周的体重与术前体重的比值明显高于 CONV 组（分别为 0.95 和 0.94，P=0.01）。
我们的结果表明，ERAS 方案在接受择期胃癌根治术的患者中是有用的。
