[Application of enhanced recovery after surgery for patients with laparoscopic radical gastrectomy]

To investigate the clinical application effects of enhanced recovery after surgery (ERAS) during perioperative period on patients undergoing laparoscopic radical gastrectomy.

A total of 127 patients with gastric cancer receiving laparoscopic radical gastrectomy in our department from July 2013 to February 2015 were prospectively enrolled. Patients were randomly divided into ERAS group (n=67) treated with ERAS method and conventional group (n=60) treated with the traditional perioperative management. The perioperative efficacy and postoperative short-term outcomes were compared between the two groups.

All the patients were recovery with no mortality during perioperative period. Compared with conventional group, patients in ERAS group showed shorter time of nasogastric tube placement[(1.4±0.6) days vs. (2.2±0.6) days, P=0.000], shorter time to first flatus [(3.2±0.9) days vs. (3.8±1.1) days, P=0.004], shorter time to first ambulation [(2.3±1.1) days vs. (4.2±6.4) days, P=0.026], shorter time to initiate oral intake (1.9±0.7) days vs. (4.0±1.1) days, P=0.000] and shorter postoperative hospital stay [(13.9±4.0) days vs. (18.7±9.1) days, P=0.000]. Visual pain scores were all significantly lower in the ERAS group as compared to the traditional group 2 hours after anesthesia awakening, 12, 24, 48 hours after operation and at the first ambulation respectively(all P<0.05). The overall complication rate was significantly lower in ERAS group than that in conventional group[14.9%(10/67) vs. 30.0%(18/60), P = 0.041]. Patients in the ERAS group had shorter postoperative hospital stay [(13.9±4.0) days vs. (18.7±9.1) days, P=0.000].

ERAS during perioperative period in laparoscopic radical gastrectomy is safe and effective, which is associated with quicker postoperative rehabilitation, better pain control and shorter hospital stay.