The Interim Analysis of Nutrition and Immune Recovery and Stress Response after Laparoscopy or Open Surgery with Fast Track or Conventional Treatment (FTMDT Trial) In Resectable Colorectal Cancer

ABSTRACT Objective To study the detailed effect of laparoscopy or open surgery with fast track or conventional treatment on patient's postoperative nutrition and immune recovery and stress response. Methods Patients with resectable colon cancer and high rectal cancer were randomized to 4 groups: (1) Laparoscopy with fast track treatment (LAFT); (2) Open surgery with fast track treatment (OSFT); (3) Laparoscopy with conventional treatment (LAC); (4) Open surgery with conventional treatment (OSC). Blood samples were collected preoperatively (baseline), and 12, 96 hours after surgery. Peripheral blood levels of albumin, prealbumin, Ig G, Ig A, Ig M and C-reactive protein (CRP) were analyzed. Results 19 patients were randomized for LAFT group, 18 for OSFT, 17 for LAC, and 19 for OSC. The four groups were balanced with respect to patients' characteristics. Mean albumin level (in percentage from baseline) was 94.35 in the LAFT group, 88.16 in the LAC group, 79.05 in the OSFT group, and 76.50 in the OSC group. Only in LAFT and LAC groups, the albumin level of 96 hours was higher than that of 12 hours, indicating the better potency of postoperative recovery of nutrition status. Similarly, postoperative Ig G levels were also highest in the LAFT group and showed the same rank with albumin levels in the 4 groups. Repeated-measures (2-way ANOVA) indicated the difference of albumin and Ig G can be attributed to surgery type and not perioperative treatment (P  Conclusions Our FTMDT randomized trial indicats: 1. laparoscopic surgery shortens the period of postoperative nutrition and immune recovery while fast track treatment retards the decrease of postoperative nutrition and immune levels; 2. Combined laparoscopic surgery with fast track treatment provides best postoperative recovery of nutrition and immune status and lowest stress response. This study was registered under NCT01080547 (ClinicalTrials.gov). Disclosure All authors have declared no conflicts of interest.