Application of enhanced recovery after surgery in laparoscopic right hemicolectomy for elderly patients

doi:10.3877/cma.j.issn.1674-0793.2017.05.004

Abstract

Abstract:

Objective

To evaluate the effect of enhanced recovery after surgery (ERAS) on elderly patients undergoing laparoscopic right hemicolectomy.

Methods

The data of seventy-seven elderly patients who received laparoscopic right hemicolectomy from December 2014 to December 2016 in the Third Affiliated Hospital of Sun Yat-sen University were collected and analyzed, among whom 39 patients received perioperative treatment according to ERAS guideline (ERAS group), and 38 patients received traditional perioperative treatment (control group).

Results

Flatus time, first ambulation time, defecation time and length of hospital stay in ERAS group were significantly shorter than control group (t=5.848, 10.758, 13.859, 5.803, all P<0.01). Compared with those in the control group, patients in ERAS group had a higher level of serum albumin after surgery, but a lower rate of postoperative nausea and vomiting (12.8% vs 57.9%, χ²=17.174, P<0.01). Moreover, patients in ERAS group reported a higher rate of inpatient satisfaction (χ²=6.829, P=0.033).

Conclusion

ERAS is safe and effective in elderly patients undergoing laparoscopic right hemicolectomy, which can improve postoperative recovery and inpatient satisfaction.

Key words: Colectomy, Laparoscopy, Aged, Enhanced recovery after surgery

Xueling Zhou, Lei Cai, Jing Su, Jianpei Liu. Application of enhanced recovery after surgery in laparoscopic right hemicolectomy for elderly patients[J]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(05): 310-313.

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References 11

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组别	例数	年龄（岁, ±s）	性别（例，男/女）	BMI（kg/m²,±s）	合并疾病（例）
组别	例数	年龄（岁, ±s）	性别（例，男/女）	BMI（kg/m²,±s）	冠心病	高血压	糖尿病	慢性阻塞性肺病
ERAS组	39	65.17±4.93	25/14	23.85±1.94	11	12	4	6
对照组	38	67.35±5.39	28/10	24.47±2.07	8	12	6	5
统计值		t=1.853	χ²=0.824	t=1.356	χ²=0.530	χ²=0.006	χ²=0.521	χ²=0.078
P值		0.068	0.364	0.179	0.467	0.939	0.470	0.780
组别	手术时间（min,±s）	手术出血（ml, ±s）	ASA分级（例）			TNM分期（例）
组别	手术时间（min,±s）	手术出血（ml, ±s）	Ⅰ级	Ⅱ级	Ⅲ级	Ⅰ期	Ⅱ期	Ⅲ期
ERAS组	154.30±32.76	51.94±26.06	9	23	7	4	19	16
对照组	166.67±35.03	55.39±24.03	10	23	5	5	20	13
统计值	t=1.601	t=0.604	χ²=0.373			χ²=0.434
P值	0.114	0.548	0.830			0.805

组别	例数	年龄（岁, ±s）	性别（例，男/女）	BMI（kg/m²,±s）	合并疾病（例）
组别	例数	年龄（岁, ±s）	性别（例，男/女）	BMI（kg/m²,±s）	冠心病	高血压	糖尿病	慢性阻塞性肺病
ERAS组	39	65.17±4.93	25/14	23.85±1.94	11	12	4	6
对照组	38	67.35±5.39	28/10	24.47±2.07	8	12	6	5
统计值		t=1.853	χ²=0.824	t=1.356	χ²=0.530	χ²=0.006	χ²=0.521	χ²=0.078
P值		0.068	0.364	0.179	0.467	0.939	0.470	0.780
组别	手术时间（min,±s）	手术出血（ml, ±s）	ASA分级（例）			TNM分期（例）
组别	手术时间（min,±s）	手术出血（ml, ±s）	Ⅰ级	Ⅱ级	Ⅲ级	Ⅰ期	Ⅱ期	Ⅲ期
ERAS组	154.30±32.76	51.94±26.06	9	23	7	4	19	16
对照组	166.67±35.03	55.39±24.03	10	23	5	5	20	13
统计值	t=1.601	t=0.604	χ²=0.373			χ²=0.434
P值	0.114	0.548	0.830			0.805

组别	例数	肛门排气时间（h）	首次下床活动时间（h）	排便时间（h）	术后住院时间（d）
ERAS组	39	40.02±9.47	26.61±5.64	50.50±8.08	8.41±2.63
对照组	38	52.32±8.97	41.44±6.44	71.94±5.13	11.58±2.13
t值		5.848	10.758	13.859	5.803
P值		0.000 1	0.000 1	0.000 1	0.000 1

组别	例数	肛门排气时间（h）	首次下床活动时间（h）	排便时间（h）	术后住院时间（d）
ERAS组	39	40.02±9.47	26.61±5.64	50.50±8.08	8.41±2.63
对照组	38	52.32±8.97	41.44±6.44	71.94±5.13	11.58±2.13
t值		5.848	10.758	13.859	5.803
P值		0.000 1	0.000 1	0.000 1	0.000 1

组别	例数	泌尿系感染	肺部感染	切口感染	深静脉血栓	恶心、呕吐	腹胀
ERAS组	39	1	1	1	0	1	1
对照组	38	3	5	2	2	6	4
χ²值		1.110	3.006	0.374	2.107	4.073	2.010
P值		0.292	0.083	0.541	0.147	0.044	0.156

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