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ORIGINAL ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 4  |  Page : 413-419

Patients Administered Neoadjuvant Chemotherapy Could be Enrolled into an Enhanced Recovery after Surgery Program for Locally Advanced Gastric Cancer


Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China

Correspondence Address:
Dr. Zhi-Wei Jiang
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.225047

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Background: Most studies on enhanced recovery after surgery (ERAS) for gastric cancer exclude patients who received neoadjuvant chemotherapy. Here, we aimed to evaluate whether patients who received neoadjuvant chemotherapy can be enrolled into the ERAS program for locally advanced gastric cancer. Methods: From April 2015 to July 2017, 114 patients who received neoadjuvant chemotherapy for locally advanced gastric cancer were randomized into ERAS and standard care (SC) groups. Postoperative length of stay, complications, bowel function, and nutritional status were recorded. Results: The postoperative length of stay of the ERAS group was shorter compared with that of the SC group (5.9 ± 5.6 vs. 8.1 ± 5.3 days, P = 0.037). The postoperative complication rate was 9.3% in the ERAS group and 11.5% in the SC group (P = 0.700). The time to first flatus (2.7 ± 2.0 vs. 4.5 ± 4.6 days, P = 0.010) and time to a semi-liquid diet (3.2 ± 2.1 vs. 6.3 ± 4.9 days, P < 0.001) in the ERAS group were shorter compared with those in the SC group. On the 10th day after surgery, the values of weight, total protein, albumin, and prealbumin of the ERAS group were lower compared with those of the SC group. Conclusions: Patients who received neoadjuvant chemotherapy could be enrolled into ERAS programs for locally advanced gastric cancer. The nutritional status of these patients was not adversely affected.

 

 Abstract in Chinese

接受新辅助化疗的局部进展期胃癌患者可被纳入加速康复外科程序

摘要

背景: 在大多数胃癌手术加速康复外科的研究中, 接受新辅助化疗的患者都被排除。 我们设计本试验的目的是用来评估接受新辅助化疗的局部进展期胃癌患者能否被纳入加速康复外科程序。

方法: 从2015年4月到2017年7月, 共有114例局部进展期胃癌患者被纳入本研究并被随机分配至加速康复外科组和传统围手术期处理组。 术后住院时间, 并发症, 肠功能恢复指标以及营养状况被记录。

结果: 加速康复外科组患者术后住院时间短于传统围手术期处理组 (5.9 ± 5.6 vs. 8.1 ± 5.3 days, P = 0.037)。 加速康复外科组中并发症发生率为9.3%, 传统围手术期处理组中并发症发生率为11.5%, 两组间并发症发生率无明显差异 (P = 0.700). 加速康复外科组术后通气时间 (2.7 ± 2.0 vs. 4.5 ± 4.6 days, P = 0.010) 和恢复半流饮食时间 (3.2 ± 2.1 vs. 6.3 ± 4.9 days, P < 0.001) 短于传统围手术期处理组。 术后第10天, 加速康复外科组患者体重, 总蛋白, 白蛋白及前白蛋白的降低程度小于传统围手术期处理组。

结论: 接受新辅助化疗的局部进展期胃癌患者能够被纳入加速康复外科程序, 而且这些患者营养状况的改变更加平缓。



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