Fast-Track Surgery Improves Postoperative Clinical Recovery and Immunity After Elective Surgery for Colorectal Carcinoma: Randomized Controlled Clinical Trial

BACKGROUND: Few clinical studies or randomized clinical trial results have reported the impact of fast-track surgery on human immunity. This study aimed to investigate the clinical and immune impact of fast-track surgery in colorectal cancer patients undergoing elective open surgery. METHODS: A controlled randomized clinical trial was conducted from November 2008 to January 2009 with a 1-month postdischarge follow-up. A total of 70 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 underwent elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters and markers of immune function were evaluated in both groups postoperatively. RESULTS: In all, 62 patients completed the study: 32 in the fast-track group and 30 in the conventional care group. Our findings revealed a significantly shorter postoperative hospital stay and faster return of gastrointestinal function in patients undergoing fast-track rehabilitation. In addition, we found a quicker response of white blood cells in the fast-track group than in the conventional care group. We also found that blood levels of globulin, immunoglobulin G, and complement 4 on postoperative day 3 were higher in the fast-track group than in the conventional care group. CONCLUSIONS: Fast-track surgery accelerates clinical recovery and improves postoperative immunity after elective open surgery for colorectal carcinoma.