The effects of fast-track surgery on inflammation and immunity in patients undergoing colorectal surgery

Int J Colorectal Dis. 2016 Oct;31(10):1675-82. doi: 10.1007/s00384-016-2630-6. Epub 2016 Aug 12.

Abstract

Objective: The objective of this study is to explore the effects of the fast-track surgery (FTS) program on inflammation and immunity in patients undergoing colorectal surgery.

Methods: From August 2014 to March 2015, a prospective and randomized controlled trial of 230 patients who underwent colorectal surgery was performed. The patients were randomly assigned to an FTS group (116 patients) or a traditional group (114 patients). Inflammatory mediators, immunological indicators, postoperative recovery indexes, and complications were compared between the two groups.

Results: The inflammatory mediators (CRP, IL-6, TNF-α) were lower in the FTS group than in the traditional group (P < 0.05) on postoperative day (POD) 1, POD 4, and POD 6, and the immunological indicators (IgG, IgA, C3, C4) of the FTS group were superior to those of the traditional group (P < 0.05) on POD 4 and POD 6. The time to first aerofluxus, defecation, oral intake, and ambulation after surgery was shorter in the FTS group than in the traditional group (P < 0.05); however, the duration of postoperative hospitalization did not differ significantly between the two groups (P > 0.05). The total complications were significantly lower in the FTS group than in the traditional group (P < 0.05).

Conclusion: The FTS program can decrease inflammation, maintain immune homeostasis, and improve rehabilitation effects in colorectal surgery patients.

Keywords: Colorectal cancer; Fast-track surgery; Immunity; Inflammation; Rehabilitation effects.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Colorectal Surgery / adverse effects*
  • Colorectal Surgery / rehabilitation
  • Female
  • Humans
  • Immunity*
  • Inflammation / etiology*
  • Inflammation Mediators / metabolism
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Period

Substances

  • Inflammation Mediators