title: Feasibility of Fast-Track Surgery in Elderly Patients with Gastric Cancer.
abstract: BACKGROUND
  The aim of this study was to investigate the role of the fast-track surgery (FTS) program in elderly patients (aged ≥75 years) who underwent open surgery for gastric cancer (GC) in China.
  
  
  METHODS
  A total of 256 patients with GC were randomly assigned to four groups, each of which consisted of 64 cases: the 45-74-year-old age group was subdivided into the FTS-1 group and the conventional care (CC)-1 group, and the 75-89-year-old age group was subdivided into the FTS-2 group and the CC-2 group. All patients underwent open gastrectomy by the same experienced surgical team. We compared the differences between the pairs of groups in different age ranges with respect to the postoperative recovery index, complications, and medical costs.
  
  
  RESULTS
  Compared with the CC-1 group, the FTS-1 group exhibited earlier postoperative flatus, a shorter postoperative hospital stay, lower medical costs, and a decreased incidence of sore throat (P = 0.010, P = 0.000, P = 0.000, and P = 0.019, respectively). Compared with the CC-2 group, the FTS-2 group had more nausea and vomiting, stomach retention, and intestinal obstruction, as well as a higher readmission rate (P = 0.015, P = 0.011, P = 0.041, and P = 0.013, respectively).
  
  
  CONCLUSIONS
  The application of FTS can significantly speed up postoperative rehabilitation, shorten the hospitalization time, and lower the medical costs for 45-74-year-old GC patients, but this procedure does not show the same benefits for elderly patients. These findings suggest that we should carefully consider whether the FTS program should be applied to elderly patients with GC.
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Bu
authors.forename: Nian
authors.initials: N
authors.lastname: Li
authors.forename: Xiong
authors.initials: X
authors.lastname: Huang
authors.forename: Shan
authors.initials: S
authors.lastname: He
authors.forename: Jing
authors.initials: J
authors.lastname: Wen
authors.forename: Xiaoting
authors.initials: X
authors.lastname: Wu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China; D004434:Early Ambulation; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D005746:Gastric Emptying; D017048:Health Care Costs; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010359:Patient Readmission; D019990:Perioperative Care / Q000379:methods*; D010612:Pharyngitis / Q000209:etiology; D020127:Recovery of Function; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology