Clinical Study Of Fast-track Surgery In Elderly Atients Undergoing Segmental Resection For Colorectal Cancer

Objective:To evaluate the safety and effectiveness of fast-track (FT) surgery in elderly patients undergoing segmental resection for colorectal cancer, then further investigate which perioperative treatment is the optimal approach for these patients.Methods:88cases of colorectal cancer patients were randomized to laparoscopic or open colorectal surgery, and to FT or standard care, resulting in4treatment groups (LAFT, LAC, OSFT and OSC). Postoperative recovery, safety index and quality of life between the4groups were evaluated.Results:Overall morbidity within30days, major complications, minor complications, reoperations, unplanned readmission within30days and in-hospital mortality did not differ significantly among the groups. The combination of laparoscopic-assisted surgery with FT care resulted in a significantly faster recovery than all other combinations, ie, LAC, OSFT and OSC. OSC treatment resulted in the worst outcome in postoperative recovery. Logistic regression analysis showed that FT care was the only independent predictive factor to reduce total hospital stay, postoperative hospital stay and days to fulfill discharge criteria. Quality of life at baseline and predischarge did not differ significantly among the groups.Conclusions:Fast-track surgery can be safely and effectively applied in elderly patients undergoing segmental resection for colorectal cancer. Optimal perioperative treatment for these patients is laparoscopic resection embedded in a FT program. If open surgery is applied, it is preferentially done in FT care.