Fast-track surgery improves postoperative recovery in patients with gastric cancer: a randomized comparison with conventional postoperative care

J Gastrointest Surg. 2010 Apr;14(4):620-7. doi: 10.1007/s11605-009-1139-5. Epub 2010 Jan 28.

Abstract

Background: Fast-track surgery is a new, promising comprehensive program for surgical patients and is beneficial to recovery. Prospective randomized, controlled clinical trials involving fast-track surgery for gastric cancer are lacking.

Patient and methods: Ninety-two patients with gastric cancer were randomly divided into a fast-track surgery group (n = 45) and conventional surgery group (n = 47). We compared outcomes (duration of postoperative stay in hospital, fever, and flatus, complications, and medical costs); postoperative serum levels of tumor necrosis factor-alpha, interleukin-6, and C-reactive protein; and resting energy expenditure between two groups.

Results: Compared with the conventional surgery group, the fast-track surgery group had no more complications (P > 0.05) with a significantly shorter duration of fever, flatus, and hospital stay, and less medical costs as well as a higher quality of life score on hospital discharge (all P < 0.05). With a significantly lower resting energy expenditure (days 1 and 3) postoperatively (P < 0.05), the fast-track surgery group showed a lower serum level of tumor necrosis factor-alpha (days 1 and 3), interleukin-6 (days 1 and 3), and C-reactive protein (days 1, 3, and 7) than the conventional surgery group (all P < 0.05).

Conclusions: Fast-track surgery can lessen postoperative stress reactions and accelerate rehabilitation for patients with gastric cancer.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Chi-Square Distribution
  • Energy Metabolism
  • Female
  • Gastrectomy / methods*
  • Humans
  • Interleukin-6 / blood
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pain Measurement
  • Postoperative Care / methods*
  • Postoperative Complications / epidemiology
  • Quality of Life
  • Statistics, Nonparametric
  • Stomach Neoplasms / rehabilitation*
  • Stomach Neoplasms / surgery*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Biomarkers
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein