To investigate the inflammatory response and immune function of fast track surgery (FTS) in elderly patients after laparoscopic rectal surgery for rectal cancer.

Between January 2014 and January 2015, rectal cancer patients undergoing laparoscopic radical resection and anus without fistula from the Third People’s Hospital of Chengdu City were selected. They were randomly divided into FTS group (23 cases) and control group (25 cases). The operation time, intraoperative bleeding volume, postoperative anal exhaust time and postoperative hospitalization time, complications, CRP, CD4, CD8, CD4/CD8, IL-6 level between the two groups 1 d preoperatively and postoperative 1, 3, 7 d, were observed and compared.

There was no significant difference between the two groups in the time of operation, the amount of bleeding and the incidence of postoperative complications. The first postoperative anal exhaust time in FTS group was shorter than that in the control group [(37±15) h vs (47±18) h, t=2.081, P<0.05], and the average length of stay was shorter [(185±13) h vs (198±25) h, t=2.23, P<0.05]. After the operation, there was significant difference in the levels of CRP at 24 h and 72 h, CD4 and IL-6 levels at 72 h and 7 d, CD8 level at 7 d, CD4/CD8 levels at 24 h and 7 d between the two groups (P<0.05). No significant difference was found in the incidence of postoperative complications between the FTS group and the control group (21.7% vs 28.0%, χ²=0.25, P=0.617).

Fast track surgery will not increase the complications of laparoscopic anal sphincter preservation surgery in middle-aged and elderly patients with rectal cancer, and can reduce and shorten the inflammatory response, reduce inflammatory damage and shorten the time of immune dysfunction.