关键词: 加速康复外科, 全腹腔镜, 胃癌, 疼痛视觉模拟评分, 语言描述评分, 日常生活能力量表

Abstract: Objective〖WTBZ〗〓To investigate the clinical effect of application of enhanced recovery after surgery（ESAS）in total laparoscopic D2 radical resection for distal gastric cancer.〖WTHZ〗Methods〖WTBZ〗〓75 patients with distal gastric cancer confirmed by endoscopy were randomly divided into 2 groups：group A was treated with accelerated rehabilitation surgery group（42 cases），and group B was treated with conventional laparoscopic group（33 cases）.The operation time，intraoperative blood loss，first anal exhaust time，first time of postoperative ambulation，and postoperative hospital stay were recorded in 2 groups.The visual analogue scale（VAS）was used to assess pain at 12h，24h，48h，and 72h after surgery.The nausea verbal descriptive scale（NVDS）was used to evaluate nausea and vomiting within 24 hours after surgery.The abdominal distension was used to evaluate bloating.The daily living ability scale（ADL）was used to evaluate daily living ability 3 days after surgery.The postoperative hemorrhage，postoperative gastroparesis，postoperative intestinal obstruction，postoperative anastomosis or stump fistula were collected from both groups.Satisfaction with postoperative pain management，postoperative nausea and vomiting control satisfaction，postoperative bloating control satisfaction and overall hospitalization satisfaction questionnaire were used.Results:There was no significant difference in the operation time  and intraoperative blood loss between the two groups（P>0.05）.Compared with group B，the time to get out of bed and the first postoperative anal exhaust time and the hospital stays in group A had decreased（P＜0.05），the VAS in group A [T12，〖LM〗T24，T48，T72 had significantly decreased（P＜0.05），the  postoperative nausea and vomiting and abdominal distensionhad significantly decreased（P＜0.05），and ADL had increased in group A（P＜0.05）.There were no serious complications such as gastric fistula，intestinal obstruction，anastomotic stoma or stump fistula in both groups.Compared with group B，the postoperative pain ，postoperative nausea and vomiting and bloating control satisfaction  and overall hospitalization satisfaction  had inncreased in group A（P＜0.05）.Conclusion:Perioperative application of ERAS in patients undergoing total laparoscopic radical gastrectomy is safe and effective.

Key words: accelerated rehabilitation surgery, total laparoscopic, gastric cancer, pain visual analogue scale, language description score, daily life ability scale