Fast Track Surgery Concept In Periodperative Of Laparoscopy-Assisted Gastrectomy For Gastric Cancer

Objective:To evaluation the clinical safety and efficacy of fast track surgery(FTS)applied in Laparoscopy-assisted gastrectomy(LAG)for gastric cancer.Methods:Five databases(PubMed、Medline、Ovid CNKI,and WAN-FANG database)were comprehensively searched(publication dates ranging from library to 2017)with controlled clinical trial(RCT)or controlled clinical trials(CCT)that compared FTS with control perioperative applied in LAG for gastric cancer.strictly screening accordance to the standard,assessing the quality of these studies,data were extracted from these trials and analyzed by the Review Manager 5.3 software.Results:1.The baseline characteristics of the selected studies:Five observational studies with a total of 315 patients(159 in FTS groups and 156 in control groups)were identified in our study.2.Comparison of recovery of intestinal motility after operation in two groups:compare with control group,FTS group were faster in recovery of intestinal motility after operation(WMD=-0.74,95%CI:-1.39--0.09 P=0.02).3.Comparison of hospital staying after operation in two groups:compare with control group,FTS group were shorter in hospital staying after operation(WMD=-1.62,95%CI:-2.86--0.38 P=0.01).4.Comparison of hospitalization expense in two groups: compare with control group,FTS group group had lower hospitalization expense(WMD =-6.37,95%CI:-10.37~-2.36;P=0.002).5.Comparison of feed time after operation in two groups :compare with control group,feed time in FTS group were earlier(WMD=-1.40,95%CI:-2.78~-0.03;P=0.04).6.Comparison of ambulation time after operation in two groups: The different between ambulation time after operation of FTS group and control groupwere not statistically significant(WMD=-0.97,95%CI:-2.27~-0.33;p=0.14).7.Comparison of complication after operation in two groups :The different between complication after operation of FTS group and control group were not statistically significant(WMD=0.93,95%CI:0.54~1.59;P=0.79).Conclusious:1.FTS applied in LAG for gastric cancer can accelerate recovery of intestinal motility,reduce hospitalization expense,shorten hospital staying time after operation.In the meantime,facilitate patients feed.2.In ambulate and complication after operation,The different between FTS group and control group were not statistically significant.3.In conclusion,FTS applied in LAG for gastric cancer were safe and effective.Because of bounded in our study,further multicenter controlled clinical trials are needed to provide theoretical support.