Application of Laparoscopy Combined with Enhanced Recovery after Surgery (ERAS) in Acute Intestinal Obstruction and Analysis of Prognostic Factors: A Retrospective Cohort Study

Abstract

Objective. A retrospective cohort study was carried out to research the effect of stent combined with laparoscopy combined with enhanced recovery after surgery (ERAS) in the operation of acute intestinal obstruction and to explore and analyze the prognostic factors. Methods. During February 2019 to April 2021, sixty patients with acute intestinal obstruction cured in our hospital were enrolled. Randomly assigned control group patients ( $n=50$ ) were divided into the research group and control group patients. The control group accepted stent combined with laparoscopic therapeutic, and the research group accepted stent combined with laparoscopic therapeutic based on ERAS. The general data, operative index, Short Form 36 (SF-36) score, visual analogue scale (VAS) score, procalcitonin (PCT), CRP, prealbumin (PA) index, curative effect, and incidence of complications were investigated. Results. No difference was found in age, gender, or type of disease among the general population ( $P>0.05$ ). A lower amount of blood was lost during the operation, less anal exhaustion was experienced by the research group, and a shorter hospital stay and lower hospitalization cost was experienced in the research group compared to the control group ( $P<0.05$ ). There exhibited no remarkable difference in SF-36 score and VAS score before operation, but after operation, the VAS score lessened, the SF-36 score augmented, while the VAS score was lower, and the SF-36 score in the research group was higher ( $P<0.05$ ). There exited no remarkable difference in the indexes of PCT, CRP, and PA before operation, but after operation, the levels of PCT and CRP lessened as well as the level of PA augmented, and the levels of PCT and CRP were lower, while the level of PA in the research group was higher. In terms of the clinical efficacy, the effective rate of the research group (98.00%) was higher compared to the control (86.00%) ( $P<0.05$ ). The main postoperative complications were pulmonary infection and incision infection. One case of incision infection occurred in the research group, and the probability of postoperative complications was 2.00%. In the control group, there were 3 cases of pulmonary infection, 0 cases of perforation, and 4 cases of incision infection, and the probability of postoperative complications was 14.00%. The prevalence in the research group was remarkably lower ( $P<0.05$ ). Conclusion. Compared with the traditional concept of surgical therapeutic, it can more effectively reduce stress reaction, relieve postoperative pain, promote the recovery of postoperative gastrointestinal function as soon as possible, and reduce postoperative complications, which is worth to explore the application in the therapeutic of acute abdomen.