Effect of fast tract surgery on immune and inflammatory reaction of elder patients with colorectal cancer
10.3760/cma.j.issn.1671-0274.2014.12.018
- VernacularTitle:快速康复外科对老年结直肠癌患者免疫功能及炎性反应的影响
- Author:
Lei MA
1
;
Lifeng WANG
;
Ke DING
;
Guangyu LIU
;
Dandan ZHANG
Author Information
1. 277599,山东省枣庄市立第四医院外科
- Keywords:
Colorectal neoplasms;
Elderly;
Fast track surgery;
Inflammatory reaction;
Influence
- From:
Chinese Journal of Gastrointestinal Surgery
2014;(12):1223-1226
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effect of rapid rehabilitation surgery (FTS) with the traditional operation method on postoperative immune function recovery , inflammatory reaction and the clinical efficacy in elderly patients with colorectal cancer. Methods A total of 144 elderly patients (older than 65 years) diagnosed as colorectal cancer in our department from February 2010 to August 2013 were prospectively enrolled in the study. According to the order of admission , patients were randomly divided into the fast track surgery group (72 cases, study group), and the traditional operation group (72 cases, control group). Preoperative and postoperative T cell subsets, inflammatory index and organ functional parameters were detected and compared. Result Basal clinical data of the two groups had no significant differences (all P>0.05). Three days after operation, CD4+ and CD8+ in both groups increased compared to preoperative levels (P<0.05), while the study group had greater increasing amplitude of CD4+(t=1.685, P=0.003), and lower CD8+(t=1.145, P=0.005) than the control group. CD4+/CD8+ increased in the study group compared to preoperation and significantly higher than that in the control group (P=0.001). Inflammatory stress indexes were significantly increased, while study group had smaller amplitude than the control group. Serum creatinine , B-natriuretic peptide and Troponin-T increased after operation , while the study group had smaller amplitude than the control group (P<0.05). The study group showed faster resumption of oral intake, quicker bowel function return, time to first defecation, hospital stay, lower incidences of nausea, vomiting, incision infection, and less cost of hospitalization. All the differences were significant (all P<0.05). Conclusion Fast track surgery can effectively protect the perioperative organ function, increase postoperative immune function, decrease inflammation stress reaction, reduce perioperative morbidity of complication, improve efficacy for elderly colorectal cancer patients.
