Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan.
Gastric Cancer. 2017 Sep;20(5):861-871. doi: 10.1007/s10120-016-0686-1. Epub 2017 Jan 6.
The feasibility of the use of the enhanced recovery after surgery (ERAS) protocol in patients with gastric cancer remains unclear.
This study was a single-center, prospective randomized trial involving patients with gastric cancer undergoing curative gastrectomy. The primary end point was the length of postoperative hospital stay. Secondary end points were the postoperative complication rate, admission costs, weight loss, and amount of physical activity.
From July 2013 to June 2015, we randomized 148 patients into an ERAS protocol group (n = 73) and a conventional protocol group (n = 69); six patients withdrew from the study. The hospital stay was significantly shorter in the ERAS protocol group than in the conventional protocol group (9 days vs 10 days; P = 0.037). The ERAS protocol group had a significantly lower rate of postoperative complications of grade III or higher (4.1% vs 15.4%; P = 0.042) and reduced costs of hospitalization (JPY 1,462,766 vs JPY 1,493,930; P = 0.045). The ratio of body weight to preoperative weight at 1 week and 1 month after the operation was higher in the ERAS protocol group (0.962 vs 0.957, P = 0.020, and 0.951 vs 0.937, P = 0.021, respectively). The ERAS protocol group recorded more physical activity in the first week after surgery.
The ERAS protocol is safe and efficient, and seems to improve the postoperative course of patients with gastric cancer.
术后加速康复（ERAS）方案在胃癌患者中的可行性尚不清楚。
这是一项单中心前瞻性随机试验，纳入了接受根治性胃切除术的胃癌患者。主要终点是术后住院时间。次要终点是术后并发症发生率、住院费用、体重减轻和体力活动量。
2013 年 7 月至 2015 年 6 月，我们将 148 例患者随机分为 ERAS 方案组（n=73）和常规方案组（n=69）；6 例患者退出研究。ERAS 方案组的住院时间明显短于常规方案组（9 天 vs 10 天；P=0.037）。ERAS 方案组术后 III 级或更高级别的并发症发生率显著较低（4.1% vs 15.4%；P=0.042），住院费用降低（JPY 1,462,766 比 JPY 1,493,930；P=0.045）。术后 1 周和 1 个月时，ERAS 方案组的体重与术前体重的比值更高（0.962 比 0.957，P=0.020；0.951 比 0.937，P=0.021）。ERAS 方案组术后第 1 周的体力活动量更多。
ERAS 方案安全有效，似乎可改善胃癌患者的术后转归。
