Effect of Enhanced Recovery After Surgery (ERAS) on C-reactive and Visceral Proteins

Summary

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.

Conditions

• Gastric Cancer

Interventions

PROCEDURE

ERAS protocols

Normal meal allowed until 6 h before surgery and Carbohydrate drink until 2 h before surgery

PROCEDURE

ERAS protocols

No bowel preparation

PROCEDURE

ERAS protocols

No nasogastric placement; if used, remove on the 1st postoperative day

PROCEDURE

ERAS protocols

Vasoactive drugs used if need be

PROCEDURE

ERAS protocols

Temperature management

PROCEDURE

ERAS protocols

Intra-abdominal drains not to be used

PROCEDURE

ERAS protocols

Intraperitoneal Ropivicaine infusion

PROCEDURE

ERAS protocols

On the 1st postoperative day Nasogastric catheter removed /Urinary catheter removed. Oral non-opioid analgesia/Drinking 0.5L liquid. Active mobilisation

PROCEDURE

ERAS protocols

On the 2nd postoperative day：Drains removed Oral diet was initiated

PROCEDURE

ERAS protocols

3-4th postoperative day： Stop oral non opioid analgesia

PROCEDURE

ERAS protocols

On the5-6th postoperative day Check discharge criteria

PROCEDURE

conventional pathway group

No solid foods at dinner before surgery and no liquids 12 h before surgery. Routine bowel preparation Nasogastric placement on the morning of surgery

PROCEDURE

conventional pathway group

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.

PROCEDURE

conventional pathway group

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

PROCEDURE

conventional pathway group

2nd postoperative day Patient is advised to get out of bed until 24-48h after surgery

PROCEDURE

conventional pathway group

3-4th postoperative day： Remove nasogastric tube after flatus Oral liquids started. Encouraged to walk in the ward.

PROCEDURE

conventional pathway group

5-6th postoperative day：Oral diet was changed from liquids to semi-fluids and normal food. Drains removed

Sponsors & Collaborators

• The First Hospital of Jilin University

  lead OTHER

Principal Investigators

• Quan Wang, Doctor · The First Hospital of Jilin University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2013-09-30

Primary Completion

2014-09-30

Completion

2014-10-31