Impact of enhanced recovery after surgery on postoperative rehabilitation, inflammation, and immunity in gastric carcinoma patients: a randomized clinical trial

Abstract

We determined the effects of enhanced recovery after surgery (ERAS) in patients undergoing radical surgery for gastric carcinoma. Sixty patients undergoing radical gastrectomy for gastric carcinoma in Lishui Hospital between March and October 2016 were randomized to receive either ERAS (30 patients) or conventional care (30 patients, controls). Clinical, economic, and laboratory indices were analyzed. ERAS patients showed faster recovery and shorter postoperative hospital stays than the controls (P<0.05). Some clinical indices (i.e., time to first flatus and defecation, time to removal of drainage tubes, time to resumption of oral feeding, time to postoperative mobilization, and postoperative complications) were significantly better in ERAS patients than in controls. Duration of postoperative infusion was lower in ERAS patients than in controls (P<0.05). In ERAS patients, serum albumin and prealbumin were higher on postoperative day 7, C-reactive protein was lower on postoperative days 3 and 7, and neutrophil count was lower on postoperative day 3 compared to the values in controls (P<0.05 for all). IgM levels were higher in ERAS patients on postoperative days 3 and 7 (P<0.05), while IgG levels were higher on postoperative day 3 (P<0.05). Total T lymphocytes were higher in ERAS patients on postoperative day 3, while helper T cells and CD4 + /CD8 + ratio were higher on postoperative days 3 and 7 (P<0.05 for all). In gastric carcinoma patients, ERAS may reduce perioperative inflammation, improve immunity and postoperative nutrition, shorten hospitalization, and enhance rehabilitation.

Surgical trauma‐induced immunosuppression in cancer: Recent advances and the potential therapies

“…In addition, patients subjected to ERAS exhibited higher serum albumin and prealbumin levels at day 7 postoperation. With regard to cellular immunity, the total T lymphocytes were higher in patients on whom ERAS was performed on postoperative day 3 215 . Despite these benefits of ERAS on short‐term results in cancer patients, little is known about its impact on long‐term results.…”

Application of enhanced recovery after surgery in perioperative patients undergoing laparoscopic surgery for gastric cancer: A meta-analysis

“…1). [20][21][22][23][24][25][26][27][28][29][30] The quality of the included literature was mainly of low and medium risk, with high reference value (Fig. 2).…”

Recovery Pattern in Different Surgical Approaches on Thoracic Enhanced Recovery based Fourteen-Step Protocol in Patients Undergoing Cardio-thoracic Surgery at University Hospital of Nepal

“…8 ERAS protocol is set to increase the quality of recovery of patients and duration of hospital stay after surgery. [9][10][11][12] In postoperative management, early mobilization within 24 hours and physiotherapy are essential tools for faster recovery. 13 Inability to mobilize early delays discharge of patients.…”