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The investigators designed a prospective randomized, controlled clinical trial then recruited 149 consecutive advanced gastric cancer patients. Further divided into a ERAS group (n=73) and a conventional pathway group (n=76). Surgical technique in both groups was same laparoscopic-assisted gastrectomy with D2 lymphadenectomy. Compared outcomes included clinical parameters and serum indicators.
Enhanced recovery after surgery combined with laparoscopic-assisted gastrectomy was successfully carried out in this study. Recovery parameters such as the length of time to return to normal diet,mean hospital stay (d) were recorded.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ERAS group | Experimental | ERAS protocols |
|
| conventional pathway group | Other | using conventional pathway |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ERAS protocols | Procedure | Normal meal allowed until 6 h before surgery and Carbohydrate drink until 2 h before surgery |
|
| Measure | Description | Time Frame |
|---|---|---|
| Compartition of postoperative hospital stay | up to 30 days after the operation |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in C-Reactive Protein( CRP) and visceral proteins level | 1day before and 1-5days after operation | baseline and 5 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Quan Wang, Doctor | The First Hospital of Jilin University | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27875094 | Derived | Mingjie X, Luyao Z, Ze T, YinQuan Z, Quan W. Laparoscopic Radical Gastrectomy for Resectable Advanced Gastric Cancer Within Enhanced Recovery Programs: A Prospective Randomized Controlled Trial. J Laparoendosc Adv Surg Tech A. 2017 Sep;27(9):959-964. doi: 10.1089/lap.2016.0057. Epub 2016 Nov 22. |
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| ERAS protocols | Procedure | No bowel preparation |
|
| ERAS protocols | Procedure | No nasogastric placement; if used, remove on the 1st postoperative day |
|
| ERAS protocols | Procedure | Vasoactive drugs used if need be |
|
| ERAS protocols | Procedure | Temperature management |
|
| ERAS protocols | Procedure | Intra-abdominal drains not to be used |
|
| ERAS protocols | Procedure | Intraperitoneal Ropivicaine infusion |
|
| ERAS protocols | Procedure | On the 1st postoperative day Nasogastric catheter removed /Urinary catheter removed. Oral non-opioid analgesia/Drinking 0.5L liquid. Active mobilisation |
|
| ERAS protocols | Procedure | On the 2nd postoperative day:Drains removed Oral diet was initiated |
|
| ERAS protocols | Procedure | 3-4th postoperative day: Stop oral non opioid analgesia |
|
| ERAS protocols | Procedure | On the5-6th postoperative day Check discharge criteria |
|
| conventional pathway group | Procedure | No solid foods at dinner before surgery and no liquids 12 h before surgery. Routine bowel preparation Nasogastric placement on the morning of surgery |
|
| conventional pathway group | Procedure | Routine use of anesthesia medicine. Standard 5-trocar laparoscopy-assisted procedure. I.V. fluids not restricted (Ringer's lactate 20 ml/kg in the first hour, then at the rate of 10-12 ml/kg/h) Routine use of abdominal drainage tubes and placement of catheters. |
|
| conventional pathway group | Procedure | 1st postoperative day: Keep Nasogastric catheter Removal of urinary catheter Opioid analgesic by intramuscular injection Parenteral nutrition until flatus. I.V. fluids not restricted Mobilization in bed |
|
| conventional pathway group | Procedure | 2nd postoperative day Patient is advised to get out of bed until 24-48h after surgery |
|
| conventional pathway group | Procedure | 3-4th postoperative day: Remove nasogastric tube after flatus Oral liquids started. Encouraged to walk in the ward. |
|
| conventional pathway group | Procedure | 5-6th postoperative day:Oral diet was changed from liquids to semi-fluids and normal food. Drains removed |
|
| ID | Term |
|---|---|
| D013274 | Stomach Neoplasms |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D013272 | Stomach Diseases |
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