探讨加速康复外科(ERAS)理念应用于全腹腔镜远端胃癌根治、胃十二指肠三角吻合术的安全性与有效性。

将2014年2月至2017年10月手术治疗的远端早期胃癌患者60例随机分为两组：ERAS组30例，应用ERAS理念进行围手术期处理；传统组30例，按传统方法进行围手术期处理，所有患者均接受同一组医师手术。采用SPSS17.0软件进行统计学分析，两组术中术后各项指标用(±s)表示，采用独立t检验；术后并发症比较采用χ²检验，P<0.05为差异有统计学意义。

ERAS组患者术后恢复肛门排气时间、腹腔引流管拔除时间、术后住院天数均缩短，术后进食时间明显提前，住院费用明显降低，与传统组相比差异均有统计学意义(P<0.05)；术后并发症包括切口感染、吻合口漏、吻合口狭窄、胃瘫、肺部感染发生率上两组差异无统计学意义(P>0.05)。

ERAS理念应用于全腹腔镜远端胃癌根治、胃十二指肠三角吻合术患者安全、有效，明显缩短术后住院时间，且不增高术后并发症发生率，可加速患者的康复。

To investigate the safety and effectiveness of the enhanced recovery after surgery (ERAS) concept in the treatment of total laparoscopic radical distal gastrectomy and Delta-Shaped Gastroduodenostomy.

60 patents with distal early gastric cancer undergoing total laparoscopic radical distal gastrectomy and Delta-Shaped Gastroduodenostomy in our hospital from February 2014 to October 2017 were randomly divided into two groups. 30 patients in the ERAS group were treated with the ERAS concept for perioperative management while 30 patients in the conventional group were treated with conventional management for perioperative period. All operations were performed by the same team of surgeons. SPSS17.0 software was used for statistical analysis. The intraoperative and postoperative data were expressed by ±s and compared with independent t test. Postoperative complications were compared by the Fisher’s Exact test. P<0.05 was considered statistically significant.

In the ERAS group, anus exhaust time after surgery, removal time of abdominal drainage tube and the length of hospital stay were all shortened. Moreover, the time of taking food after operation was significantly advanced and the hospitalization cost was reduced obviously in the ERAS group. There was a significant difference compared with the traditional group (P<0.05). There was no significant difference between two groups in the incidence rate of postoperative complications, including incision infection, anastomotic leakage, anastomotic stenosis, stomach cramps and lung infection (P>0.05).

The application of ERAS concept in the treatment of total laparoscopic radical distal gastrectomy and Delta-Shaped Gastroduodenostomy is safe and effective. It can significantly shorten the postoperative hospital stay and does not increase the incidence of postoperative complications, which can enhance the recovery of patients.