Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (9): 33-37.doi: 10.6040/j.issn.1671-7554.0.2018.756

Previous Articles    

Implementation of enhanced recovery after surgery in abdominoperineal resection of rectal cancer

WANG Haifeng, WANG Gang, ZHAO Jian, LIU Jiang, ZHOU Jiahui, JIANG Zhiwei   

  1. Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China
  • Published:2022-09-27

PDF (PC)

4

Abstract: Objective To explore the safety and efficacy of enhanced recovery after surgery(ERAS)for patients with rectal cancer treated with abdominoperineal resection(APR). Methods A retrospectivereview of 80 rectal cancer patients who underwent APR at Jinling Hospital during Feb. 2015 and Aug. 2017 was conducted. The patients were divided into ERAS group(n=40)and traditional group(n=40). The postoperative pain, eating time, intestinal function recovery time, ambulation time, stop intravenous infusion time, postoperative hospital stay and postoperative complication in the two groups were observed and compared. Results ERAS group had lower VAS pain score, earlier oral feeding and intestinal function recovery, shorter ambulation and intravenous infusion time, and shorter hospital stay than the traditional group. Postoperative perineal wound complication rate reached 15% in the traditional group, which was significantly higher than the 5% in the ERAS group(P=0.018). Conclusion ERAS is feasible and effective for rectal cancer patients undergoing APR, which can significantly shorten the postoperative hospital stay, and reduce the incidence of perineal wound complications.

Key words: Enhanced recovery after surgery, Rectal cancer, Abdominoperineal resection

CLC Number: 

  • R619
[1] Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation[J]. Br J Anaesth, 1997, 78(5): 606-617.
[2] 江志伟, 李宁, 黎介寿. 加速康复外科的概念及临床意义[J].中国实用外科杂志, 2007, 27(2): 131-133.
[3] Abdikarim I, Cao XY, Li SZ, et al. Enhanced recovery after surgery with laparoscopic radical gastrectomy for stomach carcinomas[J]. World J Gastroenterol, 2015, 21(47): 13339-13344.
[4] Bona S, Molteni M, Rosati R, et al. Introducing an enhanced recovery after surgery program in colorectal surgery: a single center experience[J]. World J Gastroenterol, 2014, 20(46): 17578-17587.
[5] Keane C, Savage S, McFarlane K, et al. Enhanced recovery after surgery versus conventional care in colonic and rectal surgery[J]. ANZ J Surg, 2012, 82(10): 697-703.
[6] 中国研究型医院学会机器人与腹腔镜外科专业委员会. 胃癌胃切除手术加速康复外科专家共识(2016版)[J]. 中华消化外科杂志, 2017, 16(1): 14-17. Robotic and Laparoscopic Surgery Committee of Chinese Research Hospital Association. Expert consensus on enhanced recovery after gastrectomy for gastric cancer(2016 edition)[J]. Chinese Journal of Digestive Surgery, 2017, 16(1): 14-17.
[7] 中华医学会肠外肠内营养学分会加速康复外科协作组. 结直肠手术应用加速康复外科中国专家共识(2015)版[J]. 中华胃肠外科杂志, 2015, 18(8): 785-787. China Enhanced Recovery after Surgery Group of Chinese Society for Parenteral and Enteral Nutrition. Chinese consensus of enhanced recovery after surgery for colorectal surgery(2015)[J]. Chinese Journal of Gastrointestinal Surgery, 2015, 18(8): 785-787.
[8] 荚卫东. 加速康复外科多学科团队建设[J]. 中华外科杂志, 2018, 56(1): 14-17. JIA Weidong. Multidisciplinary team building in enhanced recovery after surgery[J]. Chinese Journal of Surgery, 2018, 56(1): 14-17.
[9] 中华医学会外科学分会,中华医学会麻醉学分会. 加速康复外科中国专家共识暨路径管理指南(2018)[J]. 中华麻醉学杂志, 2018, 38(1): 8-13. Chinese Society of Surgery, Chinese Society of Anesthesiology. Consensus on ERAS and guidelines for pathway management in China(2018)[J]. Chinese Journal of Anesthesiology, 2018, 38(1): 8-13.
[10] Gritsenko K, Khelemsky Y, Kaye AD. Multimodal therapy in perioperative analgesia[J]. Best Pract Res Clin Anaesthesiol, 2014, 28(1): 59-79.
[11] Rafiq S, Steinbrüchel DA, Wanscher MJ, et al. Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trail[J]. J Cardiothorac Surg, 2014, 9: 52. doi: 10.1186/1749-8090-9-52.
[12] 高建军, 孙纲, 李明, 等. 折刀位经腹会阴联合直肠癌根治术[J].临床军医杂志, 2012, 40(2): 451-453.
[13] Holm T, Ljung A, Hiiggmark T, et al. Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer[J]. Br J Surg, 2007, 94(2): 232-238.
[14] Dinaux AM, Amri R, Berger DL. Prone positioning reduces perineal infections when performing the miles procedure[J]. Am J Surg, 2017, 214(2): 217-221.
[15] Showalter SL, Kelz RR, Mahmoud NN. Effect of technique on postoperative perineal wound infections in abdominoperineal resection[J]. Am J Surg, 2013, 206(1): 80-85.
[16] 鲍扬, 江志伟, 王刚, 等. 腹腔镜联合折刀位直肠癌腹会阴根治术[J]. 腹腔镜外科杂志, 2011, 16(10): 752-754. BAO Yang, JIANG Zhiwei, WANG Gang, et al. Laparoscopic Miles operation with jackknife position for low rectal carcinoma[J]. Journal of Laparoscopic Surgery, 2011, 16(10): 752-754.
[17] Liu P, Bao H, Zhang X,et al. Better operative outcomes achieved with the prone jackknife vs. lithotomy position during abdominoperineal resection in patients with low rectal cance[J]. World J Surg Oncol, 2015, 13: 39. doi: 10.1186/s12957-015-0453-5.
[1] SUN Fuyun, WANG Weipeng, ZHANG Huihui, GENG Yan, AN Xiaoxia, LI Shuangshuang, ZHANG Binbin. Correlation among personality traits and depression, anxiety symptoms in patients after colorectal cancer resection [J]. Journal of Shandong University (Health Sciences), 2021, 59(7): 91-96.
[2] DU Tiantian, LI Juan, ZHAO Yinghui, DUAN Weili, WANG Jing, WANG Yunshan, DU Lutao, WANG Chuanxin. Expression profiles of long non-coding RNA LINC02474 and effects on cell proliferation in colorectal cancer [J]. Journal of Shandong University (Health Sciences), 2021, 59(10): 57-67.
[3] LI Ning, LI Juan, XIE Yan, LI Peilong, WANG Yunshan, DU Lutao, WANG Chuanxin. Expression of LncRNA AL109955.1 in 80 cases of colorectal cancer and its effect on cell proliferation, migration and invasion [J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 38-46.
[4] WANG Bo, XIONG Ying, NI Zhifu, QU Zhenfan. Application of ERAS in day hernia surgery for children aged 1 to 3 years [J]. Journal of Shandong University (Health Sciences), 2020, 58(12): 92-96.
[5] LI Yujie, HAN Wei, HUANG Wei, DONG Yuke, LI Tao, DANG Yanwei, CAI Xiaoqing, SHEN Xiao, GONG Wendan, XU Lianfang. Application of enhanced recovery after surgery in 44 cases of uvulopalatopharyngoplasty [J]. Journal of Shandong University (Health Sciences), 2020, 58(11): 92-97.
[6] ZHI Mengwei, JIANG Zhiwei, DAI Xinjuan, WANG Gang, CHENG Wei. Clinical observation of heart rate variability in patients with gastric cancer during perioperative period under the guidance of enhanced recovery after surgery [J]. Journal of Shandong University (Health Sciences), 2020, 58(11): 85-91.
[7] HONG Jiageng, NIE Yangyang, SU Guoqiang. Effects of propofol on proliferation, migration and expressions of Wnt1 and β-catenin in colon cancer cells [J]. Journal of Shandong University (Health Sciences), 2020, 58(11): 53-58.
[8] JIANG Zhiwei, ZHOU Jiahui, CHENG Hui. Role of multimodal analgesia in enhanced recovery after surgery [J]. Journal of Shandong University (Health Sciences), 2019, 57(9): 1-4.
[9] LI Leping, CUI Huaiping, SHANG Liang. Application of enhanced recovery after surgery in gastrointestinal surgery [J]. Journal of Shandong University (Health Sciences), 2019, 57(9): 5-11.
[10] SONG Xicheng, MA Jiahai. Anesthesia management under the guidance of enhanced recovery after surgevy concept [J]. Journal of Shandong University (Health Sciences), 2019, 57(9): 12-17.
[11] JING Changqing, WANG Jinshen. Important role of evidence-based medicine in the application of enhanceel recovery aftev surgery in gastrointestinal surgery [J]. Journal of Shandong University (Health Sciences), 2019, 57(9): 18-23.
[12] WANG Gang, JIANG Zhiwei. Challenges and countermeasures in the spread of enhanced recovery after surgery [J]. Journal of Shandong University (Health Sciences), 2019, 57(9): 24-27.
[13] 8.GUO Yan, ZHANG Zheying, WANG Yunxi, WEI Xiaojuan. Expression and clinical significance of homo sapiens longevity assurance homologue 2 of yeast LAG1 in colorectal cancer [J]. Journal of Shandong University (Health Sciences), 2019, 57(7): 67-71.
[14] WAN Xiuxia, SUN Xiuping, TONG Jingjie. Anticancer effect of chrysophanol on colorectal cancer [J]. Journal of Shandong University (Health Sciences), 2019, 57(5): 74-79.
[15] GENG Xu, ZHANG Lu, LI Ming, LU Zhiming. Application value of combined detection of tumor-associated autoantibodies in the diagnosis of colorectal cancer [J]. Journal of Shandong University (Health Sciences), 2019, 57(4): 65-71.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd