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


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.
Wang
Dongsheng
D
Department of General Surgery, Affiliated Hospital of Qingdao University Medical College, Jiangsu Road 16#, Qingdao 266003, People's Republic of China.
Kong
Ying
Y
Zhong
Bei
B
Zhou
Xiaobin
X
Zhou
Yanbing
Y
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D004734:Energy Metabolism; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000534:rehabilitation* / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein