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The effects of fast-track surgery on inflammation and immunity in patients undergoing colorectal surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objective

The objective of this study is to explore the effects of the fast-track surgery (FTS) program on inflammation and immunity in patients undergoing colorectal surgery.

Methods

From August 2014 to March 2015, a prospective and randomized controlled trial of 230 patients who underwent colorectal surgery was performed. The patients were randomly assigned to an FTS group (116 patients) or a traditional group (114 patients). Inflammatory mediators, immunological indicators, postoperative recovery indexes, and complications were compared between the two groups.

Results

The inflammatory mediators (CRP, IL-6, TNF-α) were lower in the FTS group than in the traditional group (P < 0.05) on postoperative day (POD) 1, POD 4, and POD 6, and the immunological indicators (IgG, IgA, C3, C4) of the FTS group were superior to those of the traditional group (P < 0.05) on POD 4 and POD 6. The time to first aerofluxus, defecation, oral intake, and ambulation after surgery was shorter in the FTS group than in the traditional group (P < 0.05); however, the duration of postoperative hospitalization did not differ significantly between the two groups (P > 0.05). The total complications were significantly lower in the FTS group than in the traditional group (P < 0.05).

Conclusion

The FTS program can decrease inflammation, maintain immune homeostasis, and improve rehabilitation effects in colorectal surgery patients.

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Acknowledgments

This research was supported by a program of the science department of Sichuan Province, China (No. 2013SZ0026). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author contributions

Jinhua Feng and Ka Li made substantial contributions to the conception and design of this study; Li Li and Xiaodong Wang made substantial contributions to the acquisition, analysis, and interpretation of the data pertaining to the surgery and anesthesiology; Mingjun Huang, Jie Yang, and Yanjie Hu made substantial contributions to the acquisition, analysis, and interpretation of the data collected by the nursing staff; Jinhua Feng wrote the paper; and Ka Li revised it critically for important intellectual content and gave final approval of the version to be published.

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Authors and Affiliations

  1. Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China

    Jinhua Feng

  2. Nursing Department, West China Hospital of Sichuan University, Chengdu, 610041, China

    Ka Li & Mingjun Huang

  3. Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China

    Li Li, Xiaodong Wang & Jie Yang

  4. West China School of Nursing, Sichuan University, Chengdu, 610041, China

    Yanjie Hu

Authors
  1. Jinhua Feng
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  2. Ka Li
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  3. Li Li
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  4. Xiaodong Wang
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  5. Mingjun Huang
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  6. Jie Yang
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  7. Yanjie Hu
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Corresponding author

Correspondence to Ka Li.

Ethics declarations

This prospective clinical randomized trial (registration number ChiCTR-TRC-14005013) was approved by the Ethics Committee of West China Hospital of Sichuan University (Chengdu, People’s Republic of China, No. 2014/125), and written informed consent was obtained from each patient.

Conflict of interest

The authors declare that they have no competing interests.

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Feng, J., Li, K., Li, L. et al. The effects of fast-track surgery on inflammation and immunity in patients undergoing colorectal surgery. Int J Colorectal Dis 31, 1675–1682 (2016). https://doi.org/10.1007/s00384-016-2630-6

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  • DOI: https://doi.org/10.1007/s00384-016-2630-6

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