title: Fast-track surgery combined with laparoscopy could improve postoperative recovery of low-risk rectal cancer patients: a randomized controlled clinical trial.
abstract: OBJECTIVE
  In this study we aimed to assess the feasibility and safety of fast-track surgery (FTS) combined with laparoscopy for treating patients with rectal cancer and compare the results with those of the conventional perioperative intervention group.
  
  
  METHODS
  A total of 120 patients with rectal cancer were prospectively randomly assigned to the FTS combined with laparoscopy group and the conventional perioperative intervention plus laparoscopy group from November 2011 to November 2012. All patients received radical anterior resection with total mesorectal excision. Their baseline characteristics and the perioperative outcomes were recorded for analyses.
  
  
  RESULTS
  Compared with the conventional perioperative intervention group, the fast-track protocol combined with laparoscopy could shorten the time to the first flatus (53.44 ± 23.64 h vs 67.85 ± 20.12 h, P = 0.001) and first defecation (65.23 ± 22.24 h vs 86.98 ± 24.85 h, P = 0.000) after operation, accelerate the decrease of white blood cell count (P < 0.05), inhibit body temperature augmentation (P < 0.05) and reduce postoperative complication rate (16.9% vs 3.5%, P = 0.030). In addition, the length of postoperative stay was also shortened (5.05 ± 1.38 days vs 6.98 ± 2.26 days, P = 0.000). The medical cost of hospitalization was also reduced in the FTS group.
  
  
  CONCLUSIONS
  FTS in combination with laparoscopy may accelerate the clinical recovery of patients with rectal cancer after surgery.
authors.affiliation: Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Feng
authors.forename: Xiao Hua
authors.initials: XH
authors.lastname: Li
authors.forename: Hai
authors.initials: H
authors.lastname: Shi
authors.forename: Guo Sheng
authors.initials: GS
authors.lastname: Wu
authors.forename: Hong Wei
authors.initials: HW
authors.lastname: Zhang
authors.forename: Xiao Nan
authors.initials: XN
authors.lastname: Liu
authors.forename: Qing Chuan
authors.initials: QC
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001831:Body Temperature; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000534:rehabilitation; D007902:Length of Stay / Q000706:statistics & numerical data; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data; D019990:Perioperative Care / Q000379:methods* / Q000534:rehabilitation; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: complications; fast-track surgery; laparoscopy; outcome; rectal neoplasms