Effect of Enhanced Recovery after Surgery with Integrated Traditional Chinese and Western Medicine on Postoperative Stress Response of Patients with Gastrointestinal Tumors

Abstract

Objective. To investigate the effect of enhanced recovery after surgery (ERAS) with integrated traditional Chinese and Western medicine on postoperative stress response of patients suffering from gastrointestinal tumors. Methods. A total of 74 patients with gastrointestinal tumors who underwent surgical treatment in our hospital from April 2019 to March 2021 were recruited and randomized into the control group and the observation group (1 : 1). The control group received routine treatment and care, while the observation group received ERAS plus integrated traditional Chinese and Western medicine. Clinical observation was performed regarding changes in preoperative mood and postoperative pain level in each group. Changes in expression levels of plasma cortisol, C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-β (TNF-β) before and after surgery were detected in each group. Time of patients’ first fart and defecation and complications after surgery in each group were recorded. Results. The visual analogue scale (VAS) of patients in the observation group after 12 and 24 h of surgery was significantly lower than that in the control group (12 h: observation group 2.0 (1.00, 3.00) vs. control group 4.00 (3.00, 5.00), p = 0.001 ; 24 h: observation group 2.00 (1.00, 3.00) vs. control group 3.00 (2.00, 5.00), p = 0.005 ). The preoperative anxiety degree of patients in the two groups was not statistically significant ( p = 0.489 ). The plasma cortisol level of patients in the observation group after 24 and 48 h of surgery was significantly lower than that in the control group (24 h: observation group 426.54 ± 52.15 nmol/L vs. control group 508.32 ± 41.08 nmol/L, p = 0.001 ; 48 h: observation group 287.19 ± 44.24 nmol/L vs. control group 362.57 ± 43.46 nmol/L, p = 0.001 ). Patients’ postoperative CRP, IL-6, IL-8, and TNF-β expression levels in the observation group were remarkably lower than those in the control group at all time points. The first postoperative defecation came earlier in the observation group than that in the control group (observation group 76.00 h (64.50, 87.50) vs. control group 89.00 h (73.50, 116.00), p = 0.007 ). There was 1 postoperative urinary tract infection in the observation group and 1 postoperative intestinal obstruction and 1 incisional wound infection in the control group. Conclusion. ERAS with integrated traditional Chinese and Western medicine could effectively reduce the postoperative stress response and inflammatory reaction in patients with gastrointestinal tumors, contributing to the safe and quick recovery of gastrointestinal functions of patients.

Evaluating traditional Chinese medicine (TCM) Jie Geng and Huang Qi combination on reducing surgical site infections in colorectal cancer surgeries: A systematic review and meta‐analysis

“…A thorough search yielded 846 articles initially. After a comprehensive screening process, which involved eliminating duplicates, assessing full‐text availability and evaluating compliance with our inclusion criteria, a total of seven studies 10 , 11 , 12 , 13 , 14 , 15 , 16 were selected for inclusion in our meta‐analysis. These trials encompassed 1256 patients undergoing colorectal surgery, with subsets receiving TCM treatment or serving as control groups.…”

Effects of enhanced recovery after surgery on postoperative stress state and short-term complications in elderly patients with colorectal cancer

“…CRP, procalcitonin,TNF-α,IL-6,IL-10 and WBC are now the most common markers of inflammatory stress [18][19][20] that Chen use these indexes to compare the efficacy of laparoscopic surgery group for colorectal cancer versus conventional surgery group [21] . Wang's research proves that ERAS group have a lower serum level of TNF-α,IL-6 and CRP [22] .By analyzing postoperative indexes such as CRP level, Zhao believes that ERAS can effectively and safely inhibit postoperative stress response in gastric cancer patients [23] . In our study, CRP, procalcinonin, TNF-α,IL-6,IL-10 and WBC were statistically analyzed before and after surgery.…”

Effects of the enhanced recovery after surgery (ERAS) protocol on the postoperative stress state and short‐term complications in elderly patients with colorectal cancer

“…In Wang's research, patients in the ERAS group had lower serum levels of TNF‐αIL‐6 and CRP as compared to those of the patients in the non‐ERAS group 25 . By analyzing postoperative indices such as CRP levels, Zhao believed that ERAS could effectively and safely inhibit the postoperative stress response in patients with gastric cancer 26 . In our study, the CRP, procalcitonin, TNF‐α, IL‐6, IL‐10, and WBC levels were statistically analyzed before and after surgery.…”

“… 25 By analyzing postoperative indices such as CRP levels, Zhao believed that ERAS could effectively and safely inhibit the postoperative stress response in patients with gastric cancer. 26 In our study, the CRP, procalcitonin, TNF‐α, IL‐6, IL‐10, and WBC levels were statistically analyzed before and after surgery. On postoperative days 1, 3, and 5, the patients in the ERAS group had significantly lower levels of inflammatory markers than those of the patients in the non‐ERAS group, indicating that patients in the ERAS group were under a lower level of inflammatory stress, which is supported by Zhang's research.…”