Abstract： Background Few clinical studies or randomized clinical trial results have reported the impact of fast track surgery on postoperative insulin sensitivity.This study aimed to investigate the effects of fast track surgery on postoperative insulin sensitivity in patients undergoing elective open colorectal resection.Methods Controlled,randomized clinical trial was conducted from November 2008 to January 2009 with one-month post-discharge follow-up.Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups:a fast track group (35 cases) and a conventional care group (35 cases).All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia.Clinical parameters (complication rates,return of gastrointestinal function and postoperative length of stay),stress index and insulin sensitivity were evaluated in both groups perioperatively.Reaults Sixty-two patients finally completed the study,32 cases in the fast-track group and 30 cases in the conventional care group.Our findings revealed a significantly faster recovery of postoperative insulin sensitivity on postoperative day 7 in the fast-track group than that in the conventional care group.We also found a significantly shorter length of postoperative stay and a significantly faster return of gastrointestinal function in patients undergoing fast-track rehabilitation.Conclusion Fast track surgery accelerates the recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a shorter length of postoperative hospital stay.