Effects of fast track surgery on perioperative recovery, stress indicators and swallowing function in patients with thyroid cancer

Objective: To explore the effects of fast track surgery (FTS) on perioperative recovery, stress indicators and swallowing function in patients with thyroid cancer.

Methods: One hundred and thirty patients with thyroid cancer admitted to Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Affiliated Hospital of Huzhou Normal University from January 2019 to December 2020 were retrospectively included as study subjects, and were divided into a control group (n = 63, conventional nursing) and a study group (n = 67, FTS). The perioperative recovery indicators, complications, stress response, and swallowing function were compared between the two groups. Logistic regression analysis was used to analyze the risk factors for accelerating postoperative recovery.

Results: No statistically significant differences were observed in the scores of Kubota drinking test and Ichiro Fujishima rating scale (IFRS) between the two groups before intervention (P > 0.05). After nursing, the study group had lower scores of Kubota drinking test and higher scores of IFRS than the control group (P < 0.05). The time to drainage tube removal, time to first anal exhaust, time to first getting out of bed activity, length of hospitalization, and medical costs in the study group were lower than those in the control group (P < 0.05). The study group showed lower incidence of postoperative complications than the control group (8.96% vs. 28.57%, P < 0.05). The postoperative C-reactive protein, glucose, epinephrine, cortisol levels and numerical rating scale scores in the study group were lower than those in the control group (P < 0.05). Logistic regression analysis showed that age was an important negative factor for accelerating postoperative recovery of patients with thyroid cancer, and the length of postoperative hospital stay increased significantly with age (P < 0.05).

Conclusion: The intervention of FTS in the perioperative period for thyroid cancer patients can improve the swallowing function, shorten the recovery time and reduce the incidence of complications, which may be related to the improvement of the perioperative stress response of patients with FTS.