Observation of fast track surgery in patients with gastric cancer

Objective To investigate the effects of fast track surgery on patients with gastric cancer in perioperative period.Methods Ninety-two patients with gastric cancer undergone radical operations were randomly divided into two groups;fast track group (n=46,fast track surgery) and control group (n=46,traditional surgery).Serum levels of tumor necrosis factor-α (TNF-α),interleukin-6(IL-6) and C reaction protein (CRP) in the 92 patients were assayed preoperatively and at day 1,3,7 postoperatively,and the resting energy expenditure (REE) was also measured by indirect calorimetry in the morning.The postoperative hospital stay,duration of fever,medical cost,postoperative time of flatus and postoperative complications were recorded and compared respectively.Results At postoperative day 1 and 3,serum levels of TNF-α were (12.67±2.68) fmmol/L and (13.19±2.75) fmmol/L in fast track group,(14.74±3.18) fmmol/L and (15.56±2.99) fmmol/L in control group;serum levels of IL-6 were (112.52±24.73) ng/L and (129.03±22.75) ng/L in fast track group,(123.90±22.52) ng/L and (142.67±20.33) ng/L in control group.The levels of IL-6 and TNF-α in fast track group were significantly lower than those in control group (all P 0.05).The quality of life score on discharge in fast track group was significantly higher than that in control group (15.74±1.82 vs 14.67±1.27,P<0.01).Conclusion Fast track surgery can ameliorate stress reaction,decrease postoperative patients' REE during perioperative period and accelerate the rehabilitation of patients with gastric cancer. Key words: Stomach neoplasms; Energy metabolism; Cytokine; C-reactive protein; Fast track surgery