Prospective study of the effect of ERAS on postoperative recovery and complications in patients with gastric cancer

前瞻性研究ERAS对胃癌患者术后恢复及并发症的影响

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Abstract

OBJECTIVE: To study the efficacy of the enhanced recovery after surgery (ERAS) program on postoperative recovery and complications in patients with gastric cancer. METHODS: Eighty patients in the perioperative period with radical gastrectomy were enrolled and randomly divided into 2 groups, the ERAS group and the non-ERAS group. The differences between the 2 groups in terms of postoperative recoveries and complications rate were determined. According to the body mass index (BMI) level, the ERAS group was divided into 2 subgroups, namely group A (BMI < 28 kg/m(2), n = 16) and group B (BMI ≥ 28 kg/m(2), n = 24). The non-ERAS group was also divided into group C (BMI < 28 kg/m(2), n = 18) and group D (BMI ≥ 28 kg/m(2), n = 22). The recovery and complications of each group were then determined. RESULTS: The postoperative length of stay and visual analogue scale pain score were less in the ERAS group than the non-ERAS group (P < 0.05). Time to first postoperative exhaustion, first postoperative defecation, returning leukocyte count to normal, and stopping intravenous nutrition were significantly shorter in the ERAS group (n = 40), compared to the non-ERAS group (n = 40, all P < 0.05). The incidence of postoperative lower extremity intramuscular venous thrombosis was significantly higher in group D than in group B (χ(2) = 4.800, P = 0.028). In addition, the incidence of lower extremity intermuscular venous thrombosis and lung infection in group D was higher than those in other groups. CONCLUSIONS: The perioperative ERAS program was associated with faster recovery in patients undergoing radical gastrectomy. For patients with higher BMI (BMI ≥ 28 kg/m(2)), the use of the perioperative ERAS program was more advantageous.

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