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.