[Fast track rehabilitation in colonic surgery: results of a prospective trial].
OBJECTIVE
In elective large bowel surgery the incidence of general complications with standard perioperative care is up to 27%. Hospital discharge occurs 10 to 15 days after a conventional or laparoscopic colonic resection. The aim of a fast track management is to reduce the number of general complications and the length of hospital stay.


METHODS
We prospectively evaluated a multimodal protocol in our service utilizing a combined thoracic epidural analgesia, an early mobilization and oral nutrition to accelerate postoperative recovery after elective colonic surgery.


RESULTS
One hundred thirty-two consecutive patients aged an average of 66 years (range 22-88) were operated by laparotomy (n =71) or laparoscopy (n =61) and treated with the fast track rehabilitation protocol. Surgical complications occurred in 15 patients (11 %), four of these had an anastomotique leakage (3%). General complications occurred in 11 patients (8 %), the mortality was 1 %. The median length of hospital stay was four days (range 3-77) and 14 patients (11%) had to be readmitted.


CONCLUSIONS
Application of a fast track rehabilitation protocol lowered the number of general complications and reduced the duration of hospital stay in our study.
Proske
J M
JM
Service de chirurgie générale, digestive, vasculaire et thoracique, Charité-Campus-Mitte, Humboldt Universität, Berlin, Allemagne. jm.proske@abc.aphp.fr <jm.proske@abc.aphp.fr>
Raue
W
W
Neudecker
J
J
Müller
J M
JM
Schwenk
W
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000534:rehabilitation*; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors