[Elective colon surgery according to a 'fast-track' programme].
In fast-track surgical programmes, a variety ofperioperative elements are combined in an intensive multidisciplinary approach for the purpose of preserving the preoperative body composition and organ functions and actively stimulating functional recovery. Such programmes have already been introduced in several surgical procedures. The essence of fast-track colon surgery consists of extensive preoperative counselling, adequate preoperative nutrition with the avoidance of prolonged fasting, a minimum of invasive procedures and anaesthesia, no routine use of drains and nasogastric tubes, adequate perioperative analgesia encompassing high thoracic epidural anaesthesia, rapid mobilisation, rapid resumption of postoperative feeding, and medicinal support with prokinetics and laxatives. A systematic review shows that this programme accelerates recovery and hence shortens the primary and total hospital stay.
Wind
J
J
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Chirurgie, locatie G4-146.1, Postbus 22.660, 1100 DD Amsterdam.
Maessen
J
J
Polle
S W
SW
Bemelman
W A
WA
von Meyenfeldt
M F
MF
Dejong
C H C
CH
D003082:Colectomy / Q000534:rehabilitation*; D003106:Colon / Q000601:surgery*; D004434:Early Ambulation; D006801:Humans; D007430:Intraoperative Care / Q000379:methods / Q000592:standards; D007902:Length of Stay; D015201:Meta-Analysis as Topic; D011182:Postoperative Care / Q000379:methods / Q000592:standards; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D020127:Recovery of Function