Clinical application of enhanced recovery after surgery in perioperative period of adult patients with acute appendicitis

Manman LU; Qizhu FENG

ABSTRACT

Objective:

To explore the application effect and value of enhanced recovery after surgery(ERAS) in acute appendicitis.

Methods:

The clinical data of 70 cases of adult acute appendicitis in the Department of General Surgery, First Affiliated Hospital of Anhui University of Science and Technology from July 2017 to June 2018 were analyzed retrospectively, including 35 males and 35 females, aged (41.4 ± 14.6) years and ranging from 18 to 70 years. According to the different perioperative management methods, the study group was divided into study group ( n=35) and control group ( n=35). The study group adopted systematic and orderly intervention measures guided by ERAS during the perioperative period, and the control group adopted the traditional perioperative management scheme. The differences in the preoperative white blood cells, operation time, intraoperative bleeding, the first time of get out the bed, the time of anus ventilation, the 24 hour postoperative pain score, the hospital days, postoperative complications, leukocyte examination 72 days after operation and total cost were compared between the two groups. Measurement data were expressed by mean±standard deviation ( Mean± SD). T test was used for comparison between groups. Counting data were expressed by percentages, and chi-square test and Fisher test were used in comparison between groups.

Results:

In the study group, the leukocytes before operation, operation time, intraoperative blood loss, hospital stay and leukocyte examination 72 days after operation were respectively (13.3±4.7)×10 9/L, (66.5±18.7) min, (11.7±6.6) mL, (5.8±1.6) d, (7.5±2.6)×10 9/L; while the control group were respectively (13.3±3.5)×10 9/L, (71.9±21.7) min, (12.5±7.1) mL, (7.3±2.7) d, (7.9±2.4)×10 9/L. There was no significant difference between the two groups ( P> 0.05). In the study group, the first time to get out of bed, the time of anal ventilation, the 24 hour postoperative pain score, the total cost of hospitalization and postoperative complications were (8.3±1.4) h, (21.6±3.6) h, (2.3±0.5) scores, (7 058.0±1 329.9) yuan, 2 csaes; while the control group were respectively (11.1±2.8) h, (35.0±5.3) h, (3.4±0.8) scores, (8 621.3±2 625.6) yuan, 9 cases; The difference between the two groups was statistically significant ( P<0.05).

Conclusions:

The application of ERAS in the perioperative management of acute appendicitis is safe and effective. It can accelerate the anal ventilation, reduce postoperative pain, reduce postoperative complications, reduce the total hospitalization costs, and have significant social and economic benefits.