Observation of clinical efficacy of application of enhanced recovery after surgery in perioperative period on esophageal carcinoma patients.

ABSTRACT

PURPOSE: To observe the clinical efficacy of the application of enhanced recovery after surgery (ERAS) in the perioperative period of esophageal carcinoma patients. METHODS: A total of 114 patients who were admitted to Affiliated Hospital of Jining Medical University for surgical treatment of esophageal carcinoma between June 2012 and June 2016 were enrolled and randomly divided into the intervention group and the regular group according to the difference of management procedures during the perioperative period. ERAS was carried out in 57 patients in the intervention group, while conventional management procedures were applied in 57 patients in the regular group. Thereafter, compared were the fluctuations in nutritional indicators and immunological indicators, postoperative complications, time to recovery of gastrointestinal function, length of stay (LOS) in hospital and cost of patients between the two groups. RESULTS: Seven days post-operation in the intervention group, the evaluation indexes of nutrition status, including total protein (TP), albumin (ALB), prealbumin (PA) and transferrin (TF), and of immunological functions, including immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM) and total blood lymphocyte count (TLC), were significantly higher than those in the regular group. As for postoperative complications, the incidence rate of the intervention group was remarkably lower than that of the regular group; the recovery time of gastrointestinal function in the intervention group was shorter than that in the regular group; the LOS in the intervention group was also shorter than that in the regular group; the in-hospital cost in the intervention group was also lower than that in the regular group. All differences above were statistically significant (p<0.05). CONCLUSION: During the perioperative period of esophageal carcinoma patients, ERAS should be fully applied to sustain the good status, and promote the recovery of immunological functions and gastrointestinal functions; at the same time, ERAS also reduces the incidence rate of postoperative complications, LOS and in-hospital cost, and we maintain that ERAS should be performed in clinical practice.