In predefined subgroup analyses , findings did not vary by surgical approach ( open vs laparoscopic ) or colorectal condition .
CONCLUSIONS : Enhanced recovery protocol s for adults undergoing colorectal surgery improve patient outcomes with no increase in adverse events .
Evidence was insufficient regarding which components , or component combinations , are key to improving patient outcomes .
BACKGROUND : Enhanced surgical recovery protocol s are design ed to reduce hospital length of stay and health care costs .
OBJECTIVE : This study aims to systematic ally review and summarize evidence from r and omized and controlled clinical trials comparing enhanced recovery protocol s versus usual care in  adults undergoing elective colorectal surgery with emphasis on recent trials , protocol components , and subgroups for surgical approach and colorectal condition .
The effects of fast-track surgery on inflammation and immunity in patients undergoing colorectal surgery
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 prospect i ve and r and omized controlled trial of 230 patients who underwent colorectal surgery was performed . The patients were r and omly 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
In predefined subgroup analyses , findings did not vary by surgical approach ( open vs laparoscopic ) or colorectal condition .
CONCLUSIONS : Enhanced recovery protocol s for adults undergoing colorectal surgery improve patient outcomes with no increase in adverse events .
Evidence was insufficient regarding which components , or component combinations , are key to improving patient outcomes .
BACKGROUND : Enhanced surgical recovery protocol s are design ed to reduce hospital length of stay and health care costs .
OBJECTIVE : This study aims to systematic ally review and summarize evidence from r and omized and controlled clinical trials comparing enhanced recovery protocol s versus usual care in  adults undergoing elective colorectal surgery with emphasis on recent trials , protocol components , and subgroups for surgical approach and colorectal condition .