The Application of the Enhanced Recovery after Surgery Concept in the Perioperative Management of Early Gastric Cancer Patients Undergoing Endoscopic Submucosal Dissection

Objective: To explore the safety and effectiveness of the Enhanced Recovery After Surgery (ERAS) concept in perioperative nursing for early gastric cancer patients undergoing Endoscopic Submucosal Dissection (ESD). Methods: From August 2021 to December 2023, 178 patients with early gastric cancer treated with ESD at the First Affiliated Hospital of Yangtze University or Jingzhou Central Hospital were screened according to inclusion and exclusion criteria using a randomized grouping method. After excluding 51 patients, 127 patients were included (ERAS group: 62, Control group: 65). The ERAS group received perioperative care based on the ERAS concept, while the control group received conventional care. Hamilton Anxiety Rating Scale (HAMA) and Visual Analog Scale (VAS) were used to assess perioperative anxiety, pain, hunger, and thirst. Postoperative first flatus time, complications, length of hospital stay, patient satisfaction, and 30-day readmission rates were also evaluated. Results: No significant differences were found between the two groups in terms of postoperative fever, bleeding, perforation, and 30-day readmission rates. The ERAS group had significantly lower HAMA scores, VAS scores (pain, hunger, and thirst), first flatus time, incidence of postoperative nausea/vomiting and hypoglycemia/hypoglycemic reactions, and length of hospital stay compared to the control group, while patient satisfaction was higher in the ERAS group. Conclusion: The application of the ERAS concept in the perioperative care of early gastric cancer patients undergoing ESD is safe and feasible. It does not increase complications and can enhance the benefits of ESD in treating early gastric cancer.