Abstract: Objective To investigate the influence of fast track surgery on stress and inflammatory response in breast cancer patients treated with modified radical mastectomy.Methods Ninety nine patients with breast cancer undergoing modified radical mastectomy were allocated randomly to fast track surgery group(46cases)and general group(53cases).The concentrations of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8,TNF-α of each group were measured before operation,12 hour,24hour and 48hour after operation by radioimmunoassay method.Operation time,operative blood loss and hospitalization days were analyzed between the two groups,simultaneously,the incidence of subcutaneous hydrops,flap necrosis and upper limb edema were also detected.Results The concentration of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8 and TNF-α were no significantly differences in two groups before operation and at 48 hours after surgery(P＞0.05).The concentrations of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8 and TNF-α of FTS group were significantly different between the preoperative and different time points(P＜0.05).The concentration of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8 and TNF-α of FTS group were lower than that of control group at the same time point(P＜0.05).The operative time was(158.32±22.47)mins in FTS group and(161.32±22.37)mins in control group,respectively,and there were no significant statistical differences(P＞0.05).The intraoperative blood loss in the FTS group(156.98±17.09)ml was not significantly less than that in the control group(158.57±16.92)ml(P=0.644).Hospitalization days were 8.37±1.89 and 10.37±2.05 in the FTS and the control group respectively,with significant difference.The incidence of upper limb edema,subcutaneous hydrops,flap necrosis in FTS group were not less than control group.Conclusion Fast track surgery could attenuate stress and inflammatory response during,and it is safe and effective in modified radical mastectomy.

Key words: Breast cancer, Fast track surgery, Stress response, Inflammatory response