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加速康复外科在腹腔镜结直肠癌手术围手术期的临床应用

Clinical Application of Enhanced Recovery After Surgery in Perioperative Period of Laparoscopic Colorectal Cancer Surgery.

作者信息

Li Qianju, Du Lei, Lu Liesheng, Tong Yifeng, Wu Songbo, Yang Yanfei, Hu Qineng, Wang Yukun

机构信息

1 Department of Gastrointestinal Surgery, Ninghai First Hospital , Ninghai, China .

2 Department of Metabolic Surgery, Shanghai Tenth People's Hospital , Shanghai City, China .

出版信息

J Laparoendosc Adv Surg Tech A. 2019 Feb;29(2):178-183. doi: 10.1089/lap.2018.0708. Epub 2019 Jan 7.

DOI:10.1089/lap.2018.0708
PMID:30614769
Abstract

OBJECTIVE

To investigate the clinical application value of enhanced recovery after surgery (ERAS) combined with the laparoscopic technique in the radical resection of colorectal cancer.

METHODS

A total of 200 patients undergoing laparoscopic radical surgery for colorectal cancer from June 2014 to June 2017 were selected and randomly divided into ERAS group (n = 100) and conventional (CON) group (n = 100). The ERAS group adopted enhanced recovery approach after surgery for perioperative treatment, while the CON group adopted a CON approach. The operation time, blood loss, first exhaust time, first defecation time, extubation time, complication rate (incision infection, pneumonia, gastric retention, anastomotic leakage, intestinal obstruction, etc.), scores of visual analog scale (VAS) 1, 3, and 7 days after surgery, and nutritional status (albumin, total protein) 1, 3, and 7 days after surgery were compared and analyzed.

RESULTS

Compared with the CON group, the ERAS group had significantly shorter first exhaust time, first defecation time, and extubation time (all P < .05). The incidence of overall complications in the ERAS group was less than those in the CON group (P < .05); and albumin and total protein were significantly higher in the ERAS group than in the CON group (both P < .05).

CONCLUSIONS

ERAS combined with laparoscopic techniques for the treatment of colorectal cancer is a safe and feasible practice. It not only promoted the recovery of gastrointestinal function but also improved the perioperative nutritional status of patients.

摘要

目的

探讨术后加速康复(ERAS)联合腹腔镜技术在结直肠癌根治术中的临床应用价值。

方法

选取2014年6月至2017年6月行腹腔镜结直肠癌根治术的200例患者,随机分为ERAS组(n = 100)和传统(CON)组(n = 100)。ERAS组采用术后加速康复方案进行围手术期治疗,而CON组采用传统方案。比较并分析两组的手术时间、出血量、首次排气时间、首次排便时间、拔管时间、并发症发生率(切口感染、肺炎、胃潴留、吻合口漏、肠梗阻等)、术后1、3、7天的视觉模拟评分(VAS)以及术后1、3、7天的营养状况(白蛋白、总蛋白)。

结果

与CON组相比,ERAS组的首次排气时间、首次排便时间和拔管时间明显缩短(均P <.05)。ERAS组的总体并发症发生率低于CON组(P <.05);且ERAS组的白蛋白和总蛋白明显高于CON组(均P <.05)。

结论

ERAS联合腹腔镜技术治疗结直肠癌是一种安全可行的方法。它不仅促进了胃肠功能的恢复,还改善了患者的围手术期营养状况。

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