4.4 Article

Fast-track surgery combined with laparoscopy could improve postoperative recovery of low-risk rectal cancer patients: A randomized controlled clinical trial

Journal

JOURNAL OF DIGESTIVE DISEASES
Volume 15, Issue 6, Pages 306-313

Publisher

WILEY
DOI: 10.1111/1751-2980.12142

Keywords

complications; fast-track surgery; laparoscopy; outcome; rectal neoplasms

Funding

  1. National Natural Scientific Foundation of China [31100643]

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ObjectiveIn 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. MethodsA 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. ResultsCompared with the conventional perioperative intervention group, the fast-track protocol combined with laparoscopy could shorten the time to the first flatus (53.4423.64h vs 67.85 +/- 20.12h, P=0.001) and first defecation (65.23 +/- 22.24h vs 86.98 +/- 24.85h, 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. ConclusionFTS in combination with laparoscopy may accelerate the clinical recovery of patients with rectal cancer after surgery.

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