加速康复外科在腹腔镜下远端胃癌根治术中的应用  

Application of enhanced recovery after surgery in laparoscopic distal radical gastrectomy for gastric cancer

作　　者：郁飞[1] 管步高 穆四清[1] 黄德松[1] 马俊[1] YU Fei;GUAN Bu-gao;MU Si-qing;HUANG De-song;MA Jun(Department of General Surgery,Jinhu County People’s Hospital,Huai’an 211600,Jiangsu,China)

机构地区：[1]金湖县人民医院普外科,淮安211600

出　　处：《中国临床医学》2023年第5期836-839,共4页Chinese Journal of Clinical Medicine

基　　金：淮安市科技项目(HAB202144).

摘　　要：目的探讨在加速康复外科理念(ERAS)指导下腹腔镜下远端胃癌根治术的近期临床效果。方法选取2017年1月至2022年12月在金湖县人民医院普外科行腹腔镜下远端胃癌根治术的患者80例,根据干预方法的不同分为ERAS组(n=40)和对照组(n=40)。对比2组患者的手术时间、术中出血量、术后首次进食时间、首次排气时间、首次下床时间、尿管留置时间、住院天数、住院费用、术后并发症及30 d内非计划再住院情况。结果两组患者的手术时间、术中出血量以及淋巴结清扫个数等差异均无统计学意义;ERAS组的首次进食时间、首次排气时间、首次下床活动时间以及留置尿管时间均比对照组短(均P<0.05);两组均无吻合口瘘、吻合口出血、术后腹腔内出血、肠梗阻、十二指肠残端瘘等严重并发症发生,并发症发生率差异均无统计学意义。结论ERAS在腹腔镜远端胃癌根治术围手术期安全、可行,加速了患者术后康复。Objective To explore the recent clinical effects of enhanced recovery after surgery(ERAS)in laparoscopic distal radical gastrectomy for gastric cancer.Methods 80 patients who underwent laparoscopic distal gastrectomy for gastric cancer at the Department of General Surgery in Jinhu County People’s Hospital from January 2017 to December 2022 were selected and divided into ERAS group(n=40)and control group(n=40)based on different intervention methods.The surgical time,intraoperative bleeding volume,postoperative first meal time,first exhaust time,first ambulant time,urinary catheter indwelling time,hospitalization time,hospitalization expenses,incidence of complications after surgery,and unplanned rehospitalization within 30 days were compared between the two groups of patients.Results There were no significant statistical differences between the two groups in terms of surgical time,intraoperative bleeding volume,and number of lymph node dissection.The ERAS group had shorter first eating time,first exhaust time,first ambulant time,and indwelling catheter time than the control group,with statistical differences(P<0.05).There were no serious complications such as anastomotic fistula,anastomotic bleeding,postoperative intraperitoneal bleeding,intestinal obstruction,duodenal stump fistula in both groups,and there was no statistically significant difference in the incidence of complications.Conclusions The application of ERAS in the perioperative period of laparoscopic distal radical gastrectomy for gastric cancer is safe and feasible,and improves the recovery of the patients.

关 键 词：加速康复外科 腹腔镜手术 远端胃癌根治术 

分 类 号：R735.2[医药卫生—肿瘤]