DOI QR코드

DOI QR Code

Effects of the Enhanced Recovery After Surgery (ERAS) Program for Colorectal Cancer Patients Undergoing Laparoscopic Surgery

  • Jeongwon Yeom (Department of Nursing, Soonchunhyang University) ;
  • Hee-Sook Lim (Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University)
  • 투고 : 2022.04.17
  • 심사 : 2022.04.25
  • 발행 : 2022.04.30

초록

This study sought to investigate the effects of the enhanced recovery after surgery (ERAS) program on postoperative recovery and nutritional status in patients with colorectal cancer undergoing laparoscopic surgery. A total of 37 patients were included: 19 in the experimental group and 18 in the control group. The experimental group was supplemented with carbohydrate drinks before and after surgery, and the control group was maintained with fasting and water intake in the traditional method. Both care management and nutrition education were implemented for both groups. Patients were evaluated for physical condition, clinical indicators, blood tests, pain, length of stay, nutritional status, and nutrient intake. Use of the ERAS program for the experimental group resulted in shorter length of stay (p = 0.006), less pain (p < 0.001), and a lower rate of malnutrition (p = 0.014) compared with controls. In conclusion, carbohydrate drinks provide great advantages by reducing discomfort, such as pain or thirst, during fasting in patients after colon cancer surgery, helping patients to eat comfortably and actively, minimizing insulin resistance, maintaining nitrogen balance, and reducing infection and anastomosis leakage. For use of ERAS as a standardized program, repeated and expanded research is needed, and a Korean-style ERAS should be prepared by using this approach for various diseases.

키워드

참고문헌

  1. National Cancer Information Center. Cancer prevalence [Internet]. Available from https://www.cancer.go.kr/lay1/S1T639C641/contents.do [cited 2022 April 2]. 2021.
  2. Sawicki T, Ruszkowska M, Danielewicz A, Niedzwiedzka E, Arlukowicz T, Przybylowicz KE. A review of colorectal cancer in terms of epidemiology, risk factors, development, symptoms and diagnosis. Cancers (Basel) 2021;13:2025.
  3. Chen X, Jansen L, Guo F, Hoffmeister M, Chang-Claude J, Brenner H. Smoking, genetic predisposition, and colorectal cancer risk. Clin Transl Gastroenterol 2021;12:e00317.
  4. El-Shami K, Oeffinger KC, Erb NL, Willis A, Bretsch JK, Pratt-Chapman ML, Cannady RS, Wong SL, Rose J, Barbour AL, Stein KD, Sharpe KB, Brooks DD, Cowens-Alvarado RL. American Cancer Society colorectal cancer survivorship care guidelines. CA Cancer J Clin 2015;65:428-55.
  5. Lee Y, Park I, Cho H, Gwak G, Yang K, Bae BN. Effect of adjuvant chemotherapy on elderly stage II highrisk colorectal cancer patients. Ann Coloproctol 2021;37:298-305.
  6. Sheikh-Wu SF, Anglade D, Gattamorta K, Xiao C, Downs CA. Positive psychology mediates the relationship between symptom frequency and quality of life among colorectal cancer survivors during acute cancer survivorship. Eur J Oncol Nurs 2022;58:102136.
  7. Koller SE, Bauer KW, Egleston BL, Smith R, Philp MM, Ross HM, Esnaola NF. Comparative effectiveness and risks of bowel preparation before elective colorectal surgery. Ann Surg 2018;267:734-42.
  8. Jeong G, Kim K, Kwak Y. Quality of life in colorectal cancer patients according to the severity of symptom clusters classification. Asian Oncol Nurs 2014;14:74-83.
  9. Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, Rockall TA, Young-Fadok TM, Hill AG, Soop M, de Boer HD, Urman RD, Chang GJ, Fichera A, Kessler H, Grass F, Whang EE, Fawcett WJ, Carli F, Lobo DN, Rollins KE, Balfour A, Baldini G, Riedel B, Ljungqvist O. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. World J Surg 2019;43:659-95.
  10. Makaryus R, Miller TE, Gan TJ. Current concepts of fluid management in enhanced recovery pathways. Br J Anaesth 2018;120:376-83.
  11. Tian Y, Cao S, Liu X, Li L, He Q, Jiang L, Wang X, Chu X, Wang H, Xia L, Ding Y, Mao W, Hui X, Shi Y, Zhang H, Niu Z, Li Z, Jiang H, Kehlet H, Zhou Y. Randomized controlled trial comparing the short-term outcomes of enhanced recovery after surgery and conventional care in laparoscopic distal gastrectomy (GISSG1901). Ann Surg 2022;275:e15-21.
  12. Young J, Badgery-Parker T, Dobbins T, Jorgensen M, Gibbs P, Faragher I, Jones I, Currow D. Comparison of ECOG/WHO performance status and ASA score as a measure of functional status. J Pain Symptom Manage 2015;49:258-64.
  13. Ljungqvist O, de Boer HD, Balfour A, Fawcett WJ, Lobo DN, Nelson G, Scott MJ, Wainwright TW, Demartines N. Opportunities and challenges for the next phase of enhanced recovery after surgery: a review. JAMA Surg 2021;156:775-84.
  14. Kim EY, Lee IK. Survey and analysis of the application and implementations of Enhanced Recovery after Surgery (ERAS) Program for surgical patients in the major hospitals in Korea. Surg Metab Nutr 2019;10:32-45.
  15. Bisch SP, Jago CA, Kalogera E, Ganshorn H, Meyer LA, Ramirez PT, Dowdy SC, Nelson G. Outcomes of enhanced recovery after surgery (ERAS) in gynecologic oncology - A systematic review and meta-analysis. Gynecol Oncol 2021;161:46-55.
  16. Pang Q, Duan L, Jiang Y, Liu H. Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries-a systematic review. World J Surg Oncol 2021;19:191.
  17. Kim EJ, Park JS. Development and evaluation of Enhanced Recovery After Surgery Program for patients with colorectal cancer surgery. Korean J Adult Nurs 2019;31:677-90.
  18. Son GM, Kim KH, Cha SR, Yu H, Paik HJ, Joh YG. Clinical effect of clinical pathway for patients with laparoscopic colon surgery. J Pusan Natl Univ Hosp 2012;31:127-37.
  19. Mueller C, Compher C, Ellen DM; American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors. A.S.P.E.N. clinical guidelines: Nutrition screening, assessment, and intervention in adults. JPEN J Parenter Enteral Nutr 2011;35:16-24.
  20. Yeom JW, Suh YO. The effect of symptom experience, nutritional status, and self care on quality of life in elderly patients with colorectal cancer. Korean J Rehabil Nurs 2019;22:48-57.
  21. Gillis C, Richer L, Fenton TR, Gramlich L, Keller H, Culos-Reed SN, Sajobi TT, Awasthi R, Carli F. Colorectal cancer patients with malnutrition suffer poor physical and mental health before surgery. Surgery 2021;170:841-7.
  22. Zhuang CL, Ye XZ, Zhang XD, Chen BC, Yu Z. Enhanced recovery after surgery programs versus traditional care for colorectal surgery: a meta-analysis of randomized controlled trials. Dis Colon Rectum 2013;56:667-78.