加速康复外科理念在腹腔镜胃癌根治术中的应用

The concept of enhanced recovery after surgery in laparoscopic radical gastrectomy

目的探讨在腹腔镜胃癌根治术中应用加速康复外科理念的安全性及可行性。方法胃癌病人194例,择期行腹腔镜胃癌根治术,随机分为两组,实验组98例,围手术期在加速康复外科理念指导下治疗,对照组96例,围手术期应用传统方法,比较两组术后临床观察指标。结果实验组术后腹腔引流管拔除时间、胃管拔除时间、肛门恢复排气排便时间、经口流质饮食时间、半流饮食时间、住院时间明显缩短,住院费用显著降低,差异有统计学意义(P<0.05)。实验组术后肠梗阻、胃排空延迟及切口感染发生率低于对照组,差异有统计学意义(P<0.05)。结论加速康复外科理念在腹腔镜胃癌根治术中是安全可行的。

Objective To explore the safety and feasibility of Enhanced Recovery After Surgery(ERAS)in laparoscopic radical gastrectomy for gastric cancer.Methods 194 gastric cancer patients who underwent laparoscopic radical gastrectomy in our hospital were enrolled in this randomized controlled trial.The subjects were randomly divided into the ERAS program group(n=98),and the conventional control group(n=96).The clinical characteristics,recovery variables,and complications of patients were analyzed.Results In the ERAS group,the removal time of abdominal drainage tube,the time of gastric tube removal,the time of anus recovery,exhaust defecation,oral fluid diet time,half-flow diet time and hospital stay were significantly shortened,and the hospitalization cost was significantly reduced.There was statistical difference between the two groups(P<0.05).The incidence of intestinal obstruction,delayed gastric emptying,and incision infection was lower in the ERAS program group than in the control group,with a significant difference(P<0.05).Conclusion The concept of enhanced recovery after surgery is safely and effectively applied to laparoscopic radical gastrectomy for gastric cancer.