关键词: 结直肠癌, ERAS, 住院时间

Abstract: ［Abstract］ Objective To study the correlative factors which affect postoperative stay after ERAS implementation on patients with colorectal carcinoma. Methods The data were collected from 411 patients with colorectal carcinoma who underwent surgery in our department from May 2015 to September 2018. All patients completed ERAS standard procedure according to Chinese Expert Consensus on Application of Enhanced Recovery Surgery in Colorectal Operation （version 2015）. The correlation between postoperative stay and preoperative bowel preparation， preoperative carbohydrate intake， use of preventive antibiotics， perioperative preventive measures for low body temperature， targeted fluid therapy， epidural catheterization， postoperative early mobilization， postoperative early?stage feeding， use of non?steroidal painkiller， early removal of drainage tube， age， gender， body mass index， anesthesia grading in American Society of Anesthesiologists， anemia， surgical site， surgical mode， surgical time， any postoperative ICU monitoring and incidence of complication were observed. Binary Logistic regression analysis was used to analyze correlation between each variant and postoperative stay. Results There was no obvious correlation among age， gender， diabetes， body mass index， new adjuvant therapy， preoperative anemia and postoperative stay and P value was 0.705， 0.563， 0.078， 0.674， 0.323 and 0.782 respectively. Anesthesia grading in American Society of Anesthesiologists which was over or equal to 3（P=0.000， OR=8.000， 95% CI 4.080-15.686） was the factor for prolonged postoperative stay before surgery. Surgery correlative factors such as surgical approach and over 180 min surgical time were closely related to prolonged postoperative stay （P=0.025， OR=0.464， 95% CI 0.237?0.907； P<0.001， OR=15.370， 95% CI 7.828?30.175）. However， postoperative ICU monitoring treatment posed no effect on postoperative stay （P=0.645， OR=0.791， 95% CI 0.291?2.148）. Delayed postoperative early mobilization was correlated to prolonged postoperative stay （P<0.001， OR=12.149， 95% CI 5.284?27.931）. Preoperative carbohydrate intake affected postoperative stay （P=0.001， OR=0.343， 95% CI 0.179?0.658）. It certainly could shorten postoperative stay of the patients （correlation index was ?1.050）. However， there was no significant correlation between epidural catheterization pain?easing， perioperative fluid balance as well as postoperative early?stage feeding and postoperative complications and postoperative stay. Conclusion More efficient and reasonable perioperative ERAS scheme for colorectal carcinoma could shorten hospital stay and accelerate rehabilitation of patients.

Key words: colorectal carcinoma, hospital stay, ERAS