["Fast-track" rehabilitation in thoracic surgery. First experiences with a multimodal, interdisciplinary, and proven perioperative treatment course].
OBJECTIVE
"Fast-track" rehabilitation is a multimodal perioperative treatment concept for accelerating postoperative recovery which has been already used successfully in visceral surgery. Of its use in thoracic surgery however, almost no data exist and the relevance of this concept for pulmonary operations is unknown.


METHODS
In this prospective study we examined a new perioperative fast-track treatment concept for thoracic surgery and evaluated the results. This program employs detailed information of patients, intensive perioperative respiratory therapy, thoracic peridural analgesia, forced mobilization, and an early start of postoperative normal food intake.


RESULTS
Fifty consecutive patients with benign or malignant diseases of the lung aged an average of 64 years (range 22-78) were operated on thoracoscopically (n=15) or with thoracotomy (n=35) and treated perioperatively using the fast-track program. All patients were mobilized beginning 4 h postoperatively and had normal food. The incidence of general postoperative complications was 0% in this study. Postoperative stay lasted 4.5 days (range 1.5-28.5). There was no increase in surgical complications, and 6% of the patients were readmitted. The patients' acceptance of this concept was high.


CONCLUSIONS
Fast-track rehabilitation resulted in a decreased rate of general complications and accelerated rehabilitation in thoracic surgery.
Gregor
J I
JI
Universitätsklinik für Allgemein-, Visceral-, Gefäss- und Thoraxchirurgie, Charité-Campus Mitte, Charitéplatz 1, Berlin, Germany. jan.gregor@charite.de
Schwenk
W
W
Mall
J
J
Kilian
M
M
Spies
C
C
Bloch
A
A
Müller
J M
JM
Rückert
J C
JC
D015360:Analgesia, Epidural; D000768:Anesthesia, General; D004434:Early Ambulation; D005858:Germany; D006801:Humans; D007902:Length of Stay; D008171:Lung Diseases / Q000601:surgery*; D008175:Lung Neoplasms / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology; D010348:Patient Care Team; D010351:Patient Discharge; D017060:Patient Satisfaction; D011013:Pneumonectomy / Q000534:rehabilitation*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D013906:Thoracoscopy; D013908:Thoracotomy / Q000534:rehabilitation