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Purpose: To investigate the efficacy of applying fast-track surgery (FTS) to elderly patients undergoing radical resection of colorectal cancer. Methods: Elderly patients undergoing radical resection of colorectal cancer received FTS (n = 31) or routine (n = 31) nursing care. The time to first anal exhaust, oral feeding and leaving the bed, duration of postoperative hospital stay and the incidence of complications were compared between the two groups. Results: Patients receiving FTS nursing demonstrated significantly shorter times to exhaust, oral feeding and leaving the bed compared with those receiving routine nursing (all p < 0.01). Furthermore, there were significantly fewer incidences of postoperative pulmonary and urinary tract infections and intestinal adhesion in patients receiving FTS nursing (all p < 0.05). Conclusion: Application of FTS in elderly patients undergoing radical resection of colorectal cancer facilitates an early rehabilitation after surgery, but places higher demands on nursing care.