腹腔镜辅助结直肠癌手术联合加速康复外科处理的近期疗效分析

Short-term outcomes of patients treated with enhanced recovery after surgery combined with laparoscopic colorectal cancer surgery

目的探讨加速康复外科(enhanced recovery after surgery,ERAS)应用于腹腔镜结直肠癌手术的安全性及有效性。方法回顾性分析2017年3至9月北京协和医学院肿瘤医院结直肠外科完成的ERAS联合腹腔镜结直肠癌手术(ERAS组)99例和传统围手术期处理方法联合腹腔镜结直肠癌手术(对照组)103例患者的临床资料,比较两组患者各项临床指标情况结果ERAS组和对照组患者在年龄、性别、BMI、ASA分级、手术部位、手术时间、术后病理分期方面差异均无统计学意义(均P>0.05),两组出血量分别为(60±63)、(112±245)ml,术后排气时间分别为(3.0±0.8)、(4.3±1.2)(1、排便时间分别为(3.5±1.0)、(4.6±1.3)d,恢复进食时间分别为(4.1±1.2)、(5.4土2.0)d以及术后住院时间分别为(5.8±2.1).(7.8±2.5)d,差异均有统计学意义(t=-2.021、-9.216、-6.887、-5.252、-6.163,均P<0.05)。两组中均无术后30d内再入院或死亡的患者。结论ERAS应用于腹腔镜结直肠癌手术是安全有效的,有助于患者术后快速康复,缩短住院时间.

Objective To investigate the safety and efficacy of enhanced recovery after surgery (ERAS) used in laparoscopic colorectal cancer surgery. Methods We conducted a retrospective analysis of the medical records of 99 cases treated with ERAS programed laparoscopic colorectal cancer surgery (ERAS group) and 103 cases treated with traditional perioperative care and laparoscopic colorectal cancer surgery ( controlled group) from Mar 2017 to Sep 2017 in our center. Results There was no significant difference in age, gender, BMI, ASA classification, tumor location, operation time, pathological stage and the incidence of postoperative complications between ERAS group ciiul controlled group ( all P > 0. 05 ). Compared to control group, ERAS had less blood loss , shorter time to pass first flatus, stool and start diet and shorter hospitalization (lay, with all the difference statistically significant [( 60 ± 63 ) ml vs.( 112 ± 245) ml,(3. 0 ± 0. 8) d vs.(4. 3 ± 1.2 ) d,( 3. 5 ± 1.0)(1 vs.(4. 6 ± 1. 3 ) d,(4. 1 ± 1. 2) d vs.( 5. 4 ± 2.0)d,(5.8±2. l)d vs.(7. 8 ±2.5)d, t =-2.021.-9. 216、-6. 887、-5. 252、-6. 163, all P < 0.05 ]. No patients in both groups suffered from readmission or death within 30 days after surgery. Conclusion Patients treated with ERAS programed laparoscopic colorectal cancer surgery is safe and effective, with rapid recovery and reduced hospital stay.