Evaluation of the recovery speed and safety of fastest recovery after surgery vs enhanced recovery after surgery in patients undergoing gastrointestinal tumor surgery

Table 1 Baseline characteristics of patients in the fastest recovery after surgery group and the enhanced recovery after surgery group, mean ± SD/n (%)

Variable	Total	FRAS group (n = 113)	ERAS group (n = 194)	P value
Age (years)	65.55 ± 10.57	65.60 ± 22.33	65.52 ± 22.32	0.945
Sex (male)	172	67 (38.95)	105 (61.05)	0.379
BMI (kg/m2)	22.32 ± 2.49	22.33 ± 2.48	22.32 ± 2.51	0.971
Comorbidities
Hypertension	106	41 (38.68)	65 (61.32)	0.621
Diabetes	68	23 (33.82)	45 (66.18)	0.563
COPD	42	16 (38.10)	26 (61.90)	0.852
CHD	47	15 (31.91)	32 (68.09)	0.450
Smoking history	45	17 (37.78)	28 (62.22)	0.884
Alcohol consumption history	106	37 (34.91)	69 (65.09)	0.616
Tumor location				0.973
Stomach	90	34 (11.08)	56 (18.24)
Colorectal	203	74 (24.10)	129 (42.02)
Others	14	5 (1.63)	9 (2.93)
Surgical method				0.085
Laparoscopic surgery	293	113 (36.81)	189 (61.56)
Open surgery	14	0	5 (1.63)
NRS score	1.62 ± 1.44	1.48 ± 1.41	1.70 ± 1.45	0.201
6MWT	422.02 ± 41.56	416.92 ± 41.95	424.98 ± 41.15	0.101
Albumin	40.09 ± 2.83	40.04 ± 2.87	40.12 ± 2.81	0.803

BMI: Body mass index; COPD: Chronic obstructive pulmonary disease; CHD: Coronary heart disease; NRS: Nutritional Risk Screening; 6MWT: 6-minute walk test; FRAS: Fastest recovery after surgery; ERAS: Enhanced recovery after surgery.

Table 2 Comparative analysis of postoperative recovery outcomes between the fastest recovery after surgery group and the enhanced recovery after surgery group, mean ± SD

Variable	Total	FRAS group (n = 113)	ERAS group (n = 194)	P value
Operation time (minutes)	143.34 ± 38.31	139.96 ± 37.43	145.30 ± 38.77	0.239
Intraoperative blood loss (mL)	57.77 ± 12.65	55.33 ± 12.12	59.20 ± 12.77	0.01
Time to first flatus (hours)	27.42 ± 8.43	27.41 ± 7.79	27.43 ± 8.80	0.979
Time to first defecation (hours)	40.63 ± 9.33	39.34 ± 8.07	41.39 ± 9.93	0.063
Time to first mobilization	12.99 ± 8.62	4.23 ± 1.16	18.05 ± 6.81	< 0.001
Time to first oral intake	8.47 ± 5.64	2.61 ± 0.88	11.88 ± 4.28	< 0.001
Pain management score (VAS)	5.14 ± 1.44	4.85 ± 1.36	5.31 ± 1.46	0.007
Length of hospital stay (hours)	5.14 ± 1.44	22.40 ± 3.60	100.43 ± 15.91	< 0.001

VAS: Visual Analogue Scale; FRAS: Fastest recovery after surgery; ERAS: Enhanced recovery after surgery.

Table 3 Comparative analysis of the incidence and severity of postoperative complications in the two groups, n (%)

Type of complications	Total	FRAS group (n = 113)	ERAS group (n = 194)	P value
Postoperative complications	10 (3.26)	5 (4.42)	5 (2.58)	0.507
Anastomotic leakage	1	0	1 (100)	1
Intra-abdominal infection	1	0	1 (100)	1
Intestinal obstruction	7	3 (42.9)	4 (57.1)	0.711
Pulmonary infection	6	2 (33.3)	4 (66.7)	0.859
DVT	3	1 (33.3)	2 (66.7)	0.900
C-D Classification≥ grade III	1	0	1 (100)	1
Reoperation rate	2	0	2 (100)	0.279

DVT: Deep vein thrombosis; C-D: Clavien-Dindo; FRAS: Fastest recovery after surgery; ERAS: Enhanced recovery after surgery.

Table 4 Dynamic changes in inflammatory and immune parameters in both groups following surgery, mean ± SD

Indicators (units)	Group	Pre-operative	Post-operative 24 hours	Post-operative 72 hours	Post-operative 7 days	Group P value	Time × P value
CRP (mg/L)	FRAS	5.56 ± 5.15	58.69 ± 48.26	50.67 ± 40.57	42.77 ± 38.05	0.275	0.216
	ERAS	5.67 ± 4.72	56.84 ± 48.01	41.07 ± 35.97	45.16 ± 41.52
IL-6 (pg/mL)	FRAS	5.55 ± 5.13	58.68 ± 48.24	50.66 ± 40.55	42.68 ± 37.93	0.274	0.252
	ERAS	5.65 ± 4.70	56.83 ± 48.00	41.07 ± 35.96	45.06 ± 41.36
TNF-α (pg/mL)	FRAS	17.49 ± 16.66	79.30 ± 67.37	49.66 ± 42.80	34.75 ± 31.80	0.285	0.961
	ERAS	17.90 ± 15.44	76.86 ± 67.23	39.77 ± 37.48	36.13 ± 33.58
WBC (× 109/L)	FRAS	7.52 ± 1.15	11.49 ± 1.10	9.89 ± 1.03	8.46 ± 0.86	0.427	0.717
	ERAS	7.47 ± 1.25	11.62 ± 1.16	9.91 ± 1.03	8.56 ± 0.92
NEUT%	FRAS	64.00 ± 7.34	86.27 ± 5.93	78.82 ± 6.38	72.49 ± 8.01	0.617	0.923
	ERAS	63.59 ± 7.65	86.30 ± 6.10	78.28 ± 6.35	72.61 ± 7.18
LYM (× 109/L)	FRAS	1.57 ± 0.50	1.57 ± 0.50	1.60 ± 0.49	1.57 ± 0.51	0.459	0.464
	ERAS	1.58 ± 0.45	1.58 ± 0.49	1.59 ± 0.49	1.47 ± 0.51

Data were analyzed using repeated measures ANOVA. CRP: C-reactive protein; IL: Interleukin; TNF: Tumor necrosis factor; WBC: White blood cell; NEUT: Neutrophil; LYM: Lymphocyte.

Table 5 Comparative analysis of quality of life and satisfaction scores in the two patient groups, mean ± SD/n (%)

Evaluation metrics	Time point	Total	ERAS group (n = 194)	FRAS group (n = 113)	P value
EORTC QLQ-C30	1-week post-operative	61.33 ± 9.86	58.61 ± 9.66	66.01 ± 8.37	< 0.001
	1-month post-operative	74.24 ± 8.46	71.94 ± 8.57	78.17 ± 6.60	< 0.001
	3 months post-operative	83.59 ± 7.32	83.22 ± 7.44	84.22 ± 7.10	0.248
SF-36 (PF score)	1-month post-operative	76.04 ± 9.63	75.79 ± 9.99	76.46 ± 9.01	0.555
VAS satisfaction	At discharge	94.58 ± 4.78	94.14 ± 5.35	95.34 ± 3.50	0.033
	1-month post-operative	91.11 ± 5.96	90.54 ± 6.30	92.09 ± 5.23	0.028
Satisfaction with dietary recovery	1-week post-operative	3.85 ± 0.82	3.58 ± 0.83	4.31 ± 0.57	< 0.001
Readmission rate	< 30 days	10	4 (40)	6 (60)	0.122

EORTC QLQ-C30: European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30; SF-36: Short Form 36 Health Survey Questionnaire; PF: Physical functioning; VAS: Visual Analogue Scale; FRAS: Fastest recovery after surgery; ERAS: Enhanced recovery after surgery.