[Application of the protocol of enhanced recovery after surgery in colorectal surgery].
OBJECTIVE
To evaluate enhanced recovery after surgery(ERAS) protocol in colorectal surgery.


METHODS
From september 2006 to February 2007, 74 patients with colorectal cancer were randomly assigned to ERAS group and control group. The stress index, nutrition and metabolism index, intraoperative index and postoperative index were evaluated.


RESULTS
Six patients were excluded, 3 in ERAS group (2 cases received hepatectomy concomitantly and 1 case received partial ileum resection), and 3 in control group (1 case received hepatectomy and 1 case received colorectomy concomitantly, another presented asthma paroxysm). So there were 34 cases in ERAS group and 34 cases in control, with no statistical differences in sex, age, BMI index and operation types. Deviation of HOMA-IR index of ERAS was lower than the control (P>0.05), the same as plasma cortisol at the 1st day after operation (P<0.05), but plasma glucagons in the operation of ERAS group was higher than that of control (P<0.05). Plasma glucose 1st day after operation of ERAS group was lower than control (P<0.05), while plasma triglyceride intraoperation, at 1st day, 2nd day after operation of ERAS was higher than control (P<0.05). Nitrogen negative balance of ERAS group was higher than control at 2nd day after surgery, but is lower intraoperation and at 6th day after operation (P<0.05). The time of exhaust gas and stool, time to eat fluidity and semi-fluidity, out-of-bed time and exercise time per-day, residual time and complication rate in ERAS group were better than those of control (P<0.05). Post-operative expenses of ERAS was lower than that of control (P<0.05).


CONCLUSIONS
ERAS can decrease surgical stress, increase functional recovery and reduce complication rate.
Xu
Jian-min
JM
Department of General Surgery, Colorectal Cancer Research Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China. xujmin@yahoo.com.cn
Zhong
Yun-shi
YS
Zhu
De-xiang
DX
Ren
Li
L
Wei
Ye
Y
Xue
Zhang-gang
ZG
Jin
Ling
L
Niu
Wei-xin
WX
Qin
Xin-yu
XY
Wu
Zhao-Guang
ZG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D015179:Colorectal Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D003107:Colorectal Surgery / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D055815:Young Adult