ERAS外科理念在腹腔镜辅助远端胃癌根治术中的临床应用研究

目的 研究ERAS(enhanced recovery after surgery)外科理念在腹腔镜辅助下行远端胃癌根治术中的临床实用性.方法 抽取100例胃癌患者作为此次研究对象.将100例病患随机分为4组,分别为常规组(行传统开腹手术)、ERAS+开腹手术组(采用ERAS处理方法 行传统开腹手术)、腹腔镜组(行腹腔镜手术)、ERAS+腹腔镜组(采用ERAS外科处理方法 行腹腔镜手术),术前分别记录患者的一般情况(性别、体重、年龄)、术前1天(D0)ALB(血清白蛋白)水平,术后分别记录手术指标、并发症发生情况,检测术后第4天(D4)、第7天(D7)的ALB水平.比较4组病患的ALB水平、并发症等情况.结果 ①术前ALB水平为ERAS+腹腔镜组组高于另外3组,但差异无统计学意义(P>0.05);术后ERAS+腹腔镜组的ALB水平均比另外3组高,但ERAS+开腹手术组、腹腔镜组ALB水平差异无统计学意义(P>0.05).D0~D4,ERAS+腹腔镜组低于另外3组(P<0.05).术后第4天、第7天腹腔镜组病患的ALB水平明显低于ERAS+腹腔镜组(P<0.05);除常规组外的其他3组ALB水平明显高于常规组(P<0.05).②常规组、ERAS+开腹手术组不仅切口长度较腹腔镜组、ERAS+腹腔镜组长,而且术中出血量明显高于腹腔镜组、ERAS+腹腔镜组.住院时间:常规组较其他3组时间长.③术后4组病患并发症情况无明显差异,差异无统计学意义(P>0.05).结论 胃癌根治术采用ERAS外科理念行腹腔镜手术是安全可行的.

Application of ERAS Unite with Laparoscopic Surgery-assisted Distal Gastrostomy for Stomach Cancer

Objective To study the clinical usefulness of ERAS surgical laparoscopic-assisted distal gastrostomy for stomach cancer.Methods 100 cases of stomach cancer were randomly divided into 4 groups,conventional group (row traditional open surgery),ERAS +open surgery group (treatment using ERAS row traditional open surgery ),laparoscopic group (laparo-scopic surgery ) ,ERAS +laparoscopic group ( ERAS surgical treatment using laparoscopic surgery ) ,were recorded in general pa-tients (sex,weight,age),1 day before surgery (D0) ALB (serum albumin) levels before and after operation surgery indicators were recorded ,case of complications , detect postoperative day 4 ( D4 ) , on day 7 ( D7 ) of the ALB level .ALB level among 4 groups of patients ,complications ,etc.Results ① Preoperative ALB level of ERAS +laparoscopic group was higher than the other 3 groups,ERAS +open surgery group ,the laparoscopic group ALB levels continue to remain at a relatively high and stable level,the difference was not statistically significant (P>0.05);postoperative ALB levels of ERAS +laparoscopic group was higher than the other 3 groups,ERAS +open surgery group ,the laparoscopic group ALB levels continue to remain at a relatively high and stable level,the difference was not statistically significant (P>0.05); D0 to D4,ERAS +laparoscopic group were lower than the other 3 groups,the difference was statistically significant (P<0.05).And postoperative day 4,day 7,ALB level of laparoscopic group was significantly lower than ERAS +laparoscopic group , the difference was statistically significant ( P <0.05);ALB level of the other 3 groups were significantly higher than the conventional group ,the difference was statistically signif-icant (P<0.05).②Length of the incision of the conventional group ,ERAS +open surgery group was longer than laparoscopic group,ERAS +laparoscopic group,and blood loss of the conventional group ,ERAS +open surgery group was significantly high-er than laparoscopic group , ERAS +laparoscopic group .Length of stay of the conventional group was longer than the other 3 groups.③postoperative complications of the 4 groups had no significant difference ,the difference was not statistically significant (P>0.05).Conclusion Gastrectomy using ERAS laparoscopy surgical concept is safe and feasible .