title: [Fast track surgery accelerates the postoperative rehabilitation and recovery of insulin sensitivity in elective operation for colorectal carcinoma: a randomized controlled clinical trial].
abstract: OBJECTIVE
  To investigate the effects of fast track surgery on postoperative insulin sensitivity on the basis of clinical benefits in patients undergoing elective open colorectal resection.
  
  
  METHODS
  During May 2008 to December 2008, Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: a fast track group (35 cases) and a conventional care group (35 cases). All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters, stress markers and insulin sensitivity were evaluated in both groups.
  
  
  RESULTS
  The 62 patients finally completed the study, 32 cases in the fast-track group and 30 cases in the conventional care group. The speed of recovery of postoperative insulin sensitivity on 7 days postoperative in the fast-track group (97% ± 9%) was significantly faster than the conventional care group (88.5% ± 9.0%, t = 2.552, P = 0.016). The hospitalization days in the fast-track group was 6 days (M(50)), and it was significantly shorter than the conventional care group ((11.7 ± 3.8) days, Z = 4.360, P = 0.000). The time of recovery of bowel function were faster in the fast-track group (time to pass flatus was 2 days (M(50))) than the conventional care group (4 days, Z = 3.976, P = 0.000). The Infectious complication rate in the fast-track group (2/32) is lower than the other group (8/30, P = 0.040).
  
  
  CONCLUSIONS
  Fast track surgery accelerates recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a lower rate of postoperative infectious complications and a shorter length of postoperative hospital stay.
authors.affiliation: Department of Gastrointestinal-Pancreatic Surgery, Research Center of Gastric Cancer of Sun Yat-sen University, Guangzhou, China.
authors.forename: Dong-jie
authors.initials: DJ
authors.lastname: Yang
authors.forename: Wei-ling
authors.initials: WL
authors.lastname: He
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhang
authors.forename: Hua-yun
authors.initials: HY
authors.lastname: Chen
authors.forename: Wen-qi
authors.initials: WQ
authors.lastname: Huang
authors.forename: Shi-rong
authors.initials: SR
authors.lastname: Cai
authors.forename: Chuang-qi
authors.initials: CQ
authors.lastname: Chen
authors.forename: Jin-ping
authors.initials: JP
authors.lastname: Ma
authors.forename: Chang-hua
authors.initials: CH
authors.lastname: Zhang
authors.forename: Yu-long
authors.initials: YL
authors.lastname: He
authors.forename: Wen-hua
authors.initials: WH
authors.lastname: Zhan
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D011446:Prospective Studies