대장암 수술 환자의 조기회복 프로그램(ERAS) 개발 및 효과검증

Abstract

Purpose: This study aimed to develop and evaluate the effectiveness of the Enhanced Recovery After Surgery (ERAS) program for colorectal cancer surgery patients.

Methods: This program was developed using ADDIE model. It includes preoperative care (counseling, encouraging liquid food intake, avoiding mechanical bowel preparation, encouraging sips of water up to two hours before surgery) and postoperative care (removal of Foley catheter the day after surgery, water intake after three days, beginning liquid diet intake after four days, a soft diet after five days, supplementing high carbohydrate drinks beginning three days after surgery, and early mobilization on the day of surgery). An experimental group of 15 patients in the ERAS program (July 1, 2017~March 31, 2018) and a control group of 24 patients in the existing program (July 1, 2016~March 31, 2017) were compared. Date was analyzed using independent t-test, χ2 test, Fisher's exact test and Mann-Whitney U test.

Results: The time before beginning the soft diet was significantly shorter in the ERAS group than the control group (U=56.00, p<.001). The hospital stay length was significantly decreased in the ERAS group (9.53±1.35) compared to the control group (13.29±4.57) (U=72.50, p=.002). No significant differences emerged in frequencies of postoperative bowel function recovery, complications, or readmission.

Conclusion: Although the recommendations of the traditional ERAS were not fully applied in this ERAS program, it offers improved clinical outcomes for patients with laparoscopic colon cancer surgery.