Effects of Fasting Strategies on Postoperative Recovery and Long-term Prognosis in Patients With Colorectal Cancer

In 2018, colorectal cancer is the third most common malignant tumor in terms of morbidity and second mortality in the world. Surgical resection is still the main treatment for colorectal cancer.With the introduction of the ERAS, the latest international and domestic guidelines for fasting before surgery all advocate shortening the fasting time. For example, 2 hours before surgery, oral take cleared fluids, including water, sugar water, fruit juice, tea and black coffee (without milk) is allowed.Solid food can be consumed 4 hours before surgery, and oral diet should be resumed as soon as possible after surgery. Changes in diet, nutritional status, and physical activity are closely related to the incidence of colorectal cancer. Therefore, we believe that the intestine may be very sensitive to different fasting times during the perioperative period. Prolonging the fasting time may improve the prognosis by improving postoperative insulin resistance, reducing inflammation and protecting anti-tumor immune function in patients with colorectal cancer.Prolonged fasting time seems to be contrary to the results of some studies, and whether it is applicable to patients with tumor surgery is unclear. Therefore, there is an urgent need to conduct large-scale, prospective, randomized controlled clinical studies to clarify the most suitable perioperative fasting strategy (including composition, interval, and amount) for cancer patients, which can not only reduce surgical stress and speed up postoperative rehabilitation,reduce postoperative metastasis and recurrence and improve mid- and long-term prognosis.

Sex

All

Minimum age

20 Years

Maximum age

70 Years

Inclusion Criteria:

1. Age 20 \~ 70 years old
2. With BMI 20.5-25.0 kg/m2
3. Without any Endocrine and metabolic diseases
4. A stable body weight (±3 kg) for at least 6 months
5. Those diagnosed with colorectal cancer by preoperative pathology or enteroscopy
6. Patients undergoing laparoscopic radical colorectal cancer resection
7. ASA grade I-III grade
8. Initial patients have not received any treatment for bowel cancer except neoadjuvant chemotherapy
9. Patients with confirmed and feasible radical resection of colorectal cancer
10. No evidence of distant metastasis before surgery
11. Willing to participate in the research of the subject and agree to follow up regularly

Exclusion Criteria:

1. Patients with relapsed colorectal cancer who are going to undergo surgery and re-excision
2. accompanied by other malignant tumors
3. Severe malnourished patients
4. History of systemic metabolism such as diabetes
5. Before surgery, have received other treatments for colorectal cancer (such as local excision, etc.) in addition to neoadjuvant chemotherapy
6. Have a history of immunotherapy before surgery
7. Combined with basic diseases of serious heart, lung, brain, kidney and other important organs
8. Combined with severe primary diseases such as severe immune system or hematopoietic system
9. The tumor burden cannot be cured, and there is distant metastasis. Those who intend to undergo palliative surgery
10. People with gastroesophageal reflux disease, difficulty swallowing, intestinal obstruction, or difficulty in airway management
11. People who refuse to participate in the study or cannot receive long-term follow-up