Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China.
Chin Med J (Engl). 2018 Feb 20;131(4):413-419. doi: 10.4103/0366-6999.225047.
Most studies on enhanced recovery after surgery (ERAS) for gastric cancer exclude patients who received neoadjuvant chemotherapy. Here, we aimed to evaluate whether patients who received neoadjuvant chemotherapy can be enrolled into the ERAS program for locally advanced gastric cancer.
From April 2015 to July 2017, 114 patients who received neoadjuvant chemotherapy for locally advanced gastric cancer were randomized into ERAS and standard care (SC) groups. Postoperative length of stay, complications, bowel function, and nutritional status were recorded.
: The postoperative length of stay of the ERAS group was shorter compared with that of the SC group (5.9 ± 5.6 vs. 8.1 ± 5.3 days, P = 0.037). The postoperative complication rate was 9.3% in the ERAS group and 11.5% in the SC group (P = 0.700). The time to first flatus (2.7 ± 2.0 vs. 4.5 ± 4.6 days, P = 0.010) and time to a semi-liquid diet (3.2 ± 2.1 vs. 6.3 ± 4.9 days, P < 0.001) in the ERAS group were shorter compared with those in the SC group. On the 10 day after surgery, the values of weight, total protein, albumin, and prealbumin of the ERAS group were lower compared with those of the SC group.
: Patients who received neoadjuvant chemotherapy could be enrolled into ERAS programs for locally advanced gastric cancer. The nutritional status of these patients was not adversely affected.
大多数关于术后加速康复（ERAS）的研究都排除了接受新辅助化疗的胃癌患者。在这里，我们旨在评估接受新辅助化疗的患者是否可以纳入局部进展期胃癌的 ERAS 方案。
从 2015 年 4 月至 2017 年 7 月，114 例接受新辅助化疗的局部进展期胃癌患者被随机分为 ERAS 和标准护理（SC）组。记录术后住院时间、并发症、肠道功能和营养状况。
ERAS 组的术后住院时间短于 SC 组（5.9±5.6 天比 8.1±5.3 天，P=0.037）。ERAS 组的术后并发症发生率为 9.3%，SC 组为 11.5%（P=0.700）。ERAS 组首次排气时间（2.7±2.0 天比 4.5±4.6 天，P=0.010）和半流质饮食时间（3.2±2.1 天比 6.3±4.9 天，P<0.001）均短于 SC 组。术后第 10 天，ERAS 组的体重、总蛋白、白蛋白和前白蛋白值低于 SC 组。
接受新辅助化疗的患者可以纳入局部进展期胃癌的 ERAS 方案，这些患者的营养状况不会受到不良影响。
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