"Fast-track" rehabilitation after colonic surgery in elderly patients--is it feasible?
OBJECTIVE
The aim of the "fast-track" rehabilitation after elective colonic surgery is to lower the extent of general complications. Elderly patients may especially profit from this multi-modal peri-operative treatment including enforced early mobilisation and oral nutrition.


METHODS
In this prospective study using a well-defined post-operative multi-modal treatment programme, we examined the feasibility of this so-called fast-track rehabilitation in elderly patients. The programme employed combined thoracic peri-dural analgesia, early enforced mobilisation and rapid oral nutrition.


RESULTS
Seventy-four consecutive patients older than 70 years with benign or malignant disease of the large intestine were operated on. All patients were treated peri-operatively using the "fast-track" rehabilitation programme. Of the patients, 84% were able to have liquids orally on the day of surgery and 86% had solid food on the 1st post-operative day. The median time until the first bowel movement was 2 days. Only 12 (16%) patients had a total of 16 local complications, including 2 (3%) patients with anastomotic leakages. Nine patients (12%) had a total of 14 general complications; mortality rate was 1% (n=1). Patients were discharged from the hospital 5 (5th-95th percentile=4-6 days) days after surgery.


CONCLUSIONS
Using the "fast-track" rehabilitation programme on elderly patient is not only feasible but may also lower the number of general complications and the duration of the hospital stay.
Scharfenberg
M
M
Klinik für Allgemein-, Visceral-, Gefaess, und Thoraxchirurgie, Charite Universitaetsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.
Raue
W
W
Junghans
T
T
Schwenk
W
W
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000401:mortality / Q000534:rehabilitation* / Q000601:surgery*; D003672:Defecation; D004434:Early Ambulation; D004435:Eating; D017558:Elective Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010359:Patient Readmission; D011183:Postoperative Complications / Q000517:prevention & control*; D015397:Program Evaluation; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome