[Rapid recovery after colonic resection. Multimodal rehabilitation by means of Kehlet's method practiced in Vasteras].
By using a multimodal rehabilitation program professor Kehlet has shown accelerated recovery after colonic surgery with hospital stay of only two days, irrespective of open or laparoscopic technique. These results have not been confirmed in other studies. The aim of this study was to replace our traditional approach with Kehlet's multimodal regimen and try to reproduce his reported data.


METHODS
22 patients (median age 67 years) underwent right- or leftsided colectomies, 15 open (7 with midline incisions) and 7 laparoscopically. Continuous thoracic epidural, immediate mobilization and oral nutrition were used. Discharge was planned three days after surgery. On the first postoperative day all had oral intake and on the third day patients were mobilized for a median of 9.7 hours and all had resumed defecation. Pain and fatigue scores (VAS) were low. The median post-operative hospital stay was 3.5 (range 3-8) days. Two patients returned with complications. No cardiopulmonary or infectious complications were seen. The multimodal rehabilitation programme resulted in a quick recovery and a hospital stay of three days in most patients after colonic surgery.
Smedh
K
K
Kolorektalsektionen, kirurgkliniken samt operationskliniken, Centrallasarettet, Västerås. kennet.smedh@ltvastmanland.se
Strand
E
E
Jansson
P
P
Iversen
A M
AM
Matti-Andersson
A
A
Johansson
H
H
Wall
I
I
D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods; D003082:Colectomy / Q000534:rehabilitation*; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control; D010353:Patient Education as Topic; D011182:Postoperative Care / Q000191:economics / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function; D012041:Regional Medical Programs; D013548:Sweden