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| Study on enhanced recovery of pre‑rehabilitation of intestinal function in patients with colorectal cancer complicated with ileus |
| Gong Guanwen, Cheng Hui, Ge Miaomiao, Liu Jiang, Pan Huafeng, Jiang Zhiwei |
| Department of General Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medi?
cine, Nanjing 210029, Jiangsu, China |
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Abstract Objective To observe the effect of pre⁃rehabilitation of intestinal function on colorectal cancer patients with ileus.
Method 64 patients with colorectal cancer complicated with intestinal obstruction admitted to Jiangsu Hospital of Traditional
Chinese Medicine from January 2018 to October 2021 were selected and divided into the catheter group (28), the stent group(16)
and the control group (20). The catheter group received transanal decompression combined with early enteral nutrition, and
operation after 5⁃7 days. The stent group received stent decompression, combined with enteral nutrition, functional exercise,
combined with chemotherapy followed by surgery. The control group received surgery immediately after admission. The rate of
laparoscopy, rate of primary anastomosis, operation time, fever rate, incision infection rate, postoperative exhaust time and
postoperative hospital stay were observed. The inflammatory, nutritional and immune indexes of the three groups were compared.
Result At first admission, there was no significant difference in all indexes among the three groups (P>0.05). After
pre⁃rehabilitation, the ASA and NRS 2002 scores of the stent group were lower than those of the control group (P<0.05), but there
was no significant difference between the catheter group and the control group (P>0.05). ASA scores of the two groups were
different before and after pre⁃rehabilitation (P<0.05). The success rate of laparoscopic surgery and primary anastomosis in the
catheter group and the stent group was higher than that in the control group (P <0.01), but there was no significant difference in the
proportion of radical surgery among the 3 groups (P>0.05). The postoperative fever rate and incision infection rate in the two groups
were lower than those in the control group (P<0.05), and the operation time in the stent group was shorter than that in the other 2
groups (P<0.05). The postoperative exhaust time in stent group was significantly shorter than that in control group (P<0.05). The
length of postoperative hospitalization in both groups was significantly shorter than that in control group (P<0.05). CRP, WBC, N,
IL⁃6 and TNF⁃α in catheter group and stent group were significantly lower than those in control group (P<0.01). The counts of CD3+ , CD4+ and CD8+T cell in the two groups were higher than those in the control group (P <0.05), but there was no significant
difference in CD4+
/CD8+ among the 3 groups (P>0.05). Conclusion Pre⁃rehabilitation of intestinal function can effectively improve
the quality of surgery, reduce inflammation, improve nutritional and immune status of patients, reduce infectious complications, and
speed up the recovery of patients.
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Received: 08 September 2021
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