Value Of Fast Track Surgery Implementing For Colorectal Cancer Operation

AimThis study excluded the factors of the operation and anesthesia, to study patients’prognosis with the fast track surgery (FTS) process used for patients with colorectal surgery. And outcomes were assessed by clinical parameters of postoperative recovery time, nutritional status, inflammation and stress response and postoperative complications. The primary research question was whether FTS protocols had the feasibility and value and whether FTS protocols lead to less morbidity.MethodsThis study from October2009to December2011, collected361cases with elective colorectal cancer operation. A total of361patients that were diagnosed by endoscopy and pathology received FTS management (n=135) and conventional perioperative management(CPM, n=226), respectively. Outcomes were assessed by clinical parameters of preoperative general status, time to restore bowel function, time to remove nasogastric tube, time to withdraw drainage tube, time to take liquid diets, length of postoperative hospital stay, and of nutritional status, postoperative stress reaction and inflammation, postoperative morbidity and complications.ResultsAll the patients were discharged. Comparison with traditional perioperative treatment group, the FTS group revealed a significantly faster return of gastroint-estinal function, a lesser degree of postoperative inflammation and stress response and a better nutritional status(P<0.05). But the postoperative hospital stay and incid-ence of complications were no significant difference (P>0.05).The first time to passage of flatus, defecation time, time to take liquid diets, time to removal the nasogastric tube and drainage tube in FTS group were shorter or signi-fycantly ahead of the times in CPM group(P<0.05). But the difference of length of postoperative hospital stay and time to removal stitches between two groups was no statistically significant (P>0.05).Statistical main effect revealed postoperative total protein, albumin, prealbumin at a higher level in FTS group (P<0.05). Indicators of nutritional status in two groups showed a declining trend in postoperative time, in postoperative day3to the lowest point, but in postoperative day5began to recover.Statistical main effect shows postoperative blood glucose, WBC, body temper-ature at a lower level in FTS group (P＜0.05). Indicators of inflammation and stress response in two groups were significantly increased after surgery. The index at each time point also had significant difference in every group (P<0.05).One patient in the CPM group developed abdominal distention in day8, and was rehabilitated by indwelling stomach tube. Two patients in the FTS group developed abdominal distention, and exhibited vomiting in day4and day5, respectively, finally recuperated after3-4days by indwelling stomach tube.1had emerged urinary retention in FTS group, and was rehabilitated by indwelling catheter and bladder functional exercise. There were no gastric retention, wound infection, abdominal infection, lung infection and anastomotic leakage in two groups. Postoperative adverse reactions and incidence of complications were no significant differences in two groups (P>0.05).Conclusion1. Application of FTS process was feasible and effective for colorectal cancer operation.2. FTS process could shorten the time to restore gastrointestinal function, sped up the time to resume oral eating, and accelerate postoperative recovery. 3. FTS process could reduce postoperative inflammation and stress response, and improve the nutritional status of postoperative patients.4. FTS process did not increase the incidence of postoperative complications.