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.

PATIENT AND 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.