A protocol for a proof of concept, single-centre study on the effects of high fraction supplemental perioperative oxygen on inflammation, immune function and early postoperative outcomes in surgery for colorectal cancer

The use of laparoscopic techniques in surgery has revolutionised the field by reducing hospitalisation times, postoperative infectious complications and pain. This has resulted in a significant improvement in short and long-term outcomes. Reduced surgical stress and, by extension, better preservation of immune function and reduced systemic inflammation play a key role in this. Recent studies have shown the merit of the use of high fractions of supplemental perioperative oxygen (SPO) in reducing surgical stress. Evidence exists that it may further improve postoperative outcomes after certain laparoscopic and open surgical procedures by reducing complication rates and suppressing stimulus induced inflammatory cytokine production. While studies have been conducted on the use of high fractions of SPO, few have addressed its use in major surgical procedures, with no studies addressing its use in surgical oncology. This paper will explore the current literature on the topic, provide basis for further studies and detail the protocol for an upcoming single centre superiority study to investigate the use of high fractions of SPO on immune and inflammatory outcomes in patients undergoing surgery for colorectal cancer.