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加速康复外科在合并糖尿病的胃癌患者中的可行性。

Feasibility of ERAS in Patients With Gastric Cancer Complicated by Diabetes Mellitus.

机构信息

191612Affiliated Hospital of Jiangsu University, Zhenjiang, China.

出版信息

Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221118211. doi: 10.1177/15330338221118211.

Abstract

Enhanced Recovery After Surgery (ERAS) is the integration of multiple perioperative evidence-based medical practices into a single pathway aimed at eliminating surgical liabilities and improving treatment accuracy to enhance patients' postoperative outcomes. The ERAS Society has been developing guidelines that are widely applicable in the surgical field. ERAS pathways in selective and noncomplicated cases are extensively practiced. However, the ERAS literature excludes patients with comorbidities, such as gastric cancer complicated with diabetes mellitus (DM). Current ERAS guidelines exclude patients with DM in enhanced recovery programs because of insufficient evidence-based medicine on the molecular physiology of the patients in response to surgical insult. Therefore, it is important to implement accelerated rehabilitation surgery for patients with gastric cancer and DM. This review discusses the feasibility and necessity of applying ERAS guidelines to patients with gastric cancer complicated by DM. In addition, we documented the need to lay a logical foundation for enhanced recovery after surgery in patients with gastric cancer complicated by DM.

摘要

术后加速康复(ERAS)是将多个围手术期循证医学实践整合到一个单一的路径中,旨在消除手术风险并提高治疗准确性,以改善患者的术后结局。ERAS 协会一直在制定广泛适用于外科领域的指南。在选择性和非复杂性病例中广泛实施 ERAS 路径。然而,ERAS 文献排除了患有合并症的患者,例如患有糖尿病(DM)的胃癌患者。由于针对手术创伤的患者分子生理学缺乏循证医学证据,目前的 ERAS 指南将 DM 患者排除在增强恢复计划之外。因此,为患有胃癌和 DM 的患者实施加速康复手术非常重要。本综述讨论了将 ERAS 指南应用于患有糖尿病合并胃癌患者的可行性和必要性。此外,我们记录了为患有糖尿病合并胃癌的患者实施手术后康复增强措施奠定逻辑基础的必要性。

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Prediabetes and diabetes in relation to risk of gastric adenocarcinoma.糖尿病前期和糖尿病与胃腺癌风险的关系。
Br J Cancer. 2019 Jun;120(12):1147-1152. doi: 10.1038/s41416-019-0470-1. Epub 2019 May 7.

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