Abstract:

Objective

To explore the influence of transumbilical single-port laparoscopic cholecystectomy （LESS） under the concept of enhanced recovery after surgery （ERAS） on the postoperative recovery of patients.

Methods

A total of 120 patients with benign gallbladder diseases who underwent LESS from December 2020 to November 2023 were selected.They were randomly divided into a control group（n=60 cases） and an observation group （n=60 cases） at a ratio of 1：1.Patients in the control group received conventional peri-operative management plus LESS，while patients in the observation group received ERAS concept-based management plus LESS.The SPSS 25.0 software was used for statistical analysis of the data.Measurement data such as serum stress indicators，numerical rating scale （NRS） for postoperative pain assessment，and peri-operative indicators were expressed as （±s），and independent sample t test was used for comparison between groups； Count data such as the incidence of postoperative complications were expressed as［ cases （%）］，and the χ² test was used.A P value ＜ 0.05 indicated a statistically significant difference.

Results

One day after the operation，the levels of reactive oxygen species （ROS），superoxide dismutase （SOD），malondialdehyde （MDA），and C-reactive protein （CRP） in the observation group were lower than those in the control group （P＜0.05）.The NRS scores of the observation group were lower than those of the control group at 6h，12h，24h，and 48h after the operation （P＜0.05）.In terms of the time to first out-of-bed activity，recovery of exhaust，first eating，length of hospital stay，as well as the intraoperative and postoperative fluid infusion volume，the values in the observation group were lower than those in the control group （P＜0.05）.The proportion of patients with adverse reactions in the observation group was 3.3%，which was lower than 15.0% in the control group （P＜0.05）.

Conclusion

Implementing intervention management under the ERAS concept during the peri-operative period of LESS can alleviate surgical stress and inflammatory responses in patients，relieve postoperative pain，promote postoperative recovery，reduce unnecessary fluid infusion，and lower the incidence of postoperative complications，with a remarkable intervention effect.

Key words: Gallbladder Benign Diseases, Transumbilical Single Hole, Cholecystectomy,Laparoscopic, Enhanced Recovery After Surgery, Prognosis