Abstract
BackgroundFew clinical studies or randomized clinical trial results have reported the impact of fast-track surgery on human immunity. This study aimed to investigate the clinical and immune impact of fast-track surgery in colorectal cancer patients undergoing elective open surgery.MethodsA controlled randomized clinical trial was conducted from November 2008 to January 2009 with a 1-month postdischarge follow-up. A total of 70 patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: a fast-track group (35 cases) and a conventional care group (35 cases). All included patients underwent elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters and markers of immune function were evaluated in both groups postoperatively.ResultsIn all, 62 patients completed the study: 32 in the fast-track group and 30 in the conventional care group. Our findings revealed a significantly shorter postoperative hospital stay and faster return of gastrointestinal function in patients undergoing fast-track rehabilitation. In addition, we found a quicker response of white blood cells in the fast-track group than in the conventional care group. We also found that blood levels of globulin, immunoglobulin G, and complement 4 on postoperative day 3 were higher in the fast-track group than in the conventional care group.ConclusionsFast-track surgery accelerates clinical recovery and improves postoperative immunity after elective open surgery for colorectal carcinoma.
Highlights
Fast-track surgery (FTS) is a promising comprehensive program for surgical patients
We found that blood levels of globulin, immunoglobulin G, and complement 4 on postoperative day 3 were higher in the fast-track group than in the conventional care group
Three patients were excluded from the FTS group and five patients from the conventional care group. (Fig. 1) Patients in the two groups had comparable preoperative baseline characteristics, including sex, age, serum hemoglobin and albumin levels, and body mass index (Table 1)
Summary
Fast-track surgery (FTS) is a promising comprehensive program for surgical patients. It aims to decrease the perioperative stress response to the surgical trauma, thereby leading to a decrease in complication rates after elective surgery [1, 2]. Numerous clinical trials have provided positive evidence of the benefits of utilizing FTS, including improving postoperative recovery, shortening the hospital stay, accelerating the return of gastrointestinal function, and reducing morbidity and mortality rates [3,4,5,6]. Few clinical studies or randomized clinical trial (RCT) results have reported the impact of FTS on human immunity. Based on the hypothesis and present evidence of the benefits of FTS, this prospective, randomized comparative study investigated the effects of FTS on postoperative clinical recovery and immunity in patients with colorectal carcinoma undergoing elective open surgery. Few clinical studies or randomized clinical trial results have reported the impact of fast-track surgery on human immunity. This study aimed to investigate the clinical and immune impact of fast-track surgery in colorectal cancer patients undergoing elective open surgery. We found that blood levels of globulin, immunoglobulin G, and complement 4 on postoperative day 3 were higher in the fast-track group than in the conventional care group
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