Early discharge following liver resection for colorectal metastases.
OBJECTIVE
Liver resection is currently the recognised treatment for localised colorectal liver metastases. Hospital stay in recently published series is between seven and 12 days for open surgery and five and eight days for laparoscopic resection. Recently there has been interest in the use of 'fast-track' recovery protocols following major abdominal surgery. Our aim was to measure the effect of such a protocol on hospital stay following liver resection.


METHODS
Data was collected prospectively from 12 consecutive patients undergoing open liver resection between August 2003 and September 2004. All patients had a large subcostal incision with full mobilisation of the liver. A 'fast-track' protocol was employed consisting of intra venous fluid restriction, patient controlled analgesia and early diet and mobilisation. Data on postoperative complications and hospital stay was recorded.


RESULTS
Twelve patients with a median age of 60 (range 43-74) years underwent liver resection. Resection consisted of one hepatic lobectomy, two trisegmentectomies, three bisegmentectomies and six segmentectomies. Median hospital stay was four (range two to seven) days. One epileptic patient developed carbamazepine toxicity delaying their discharge. A further patient developed a collection requiring no intervention.


CONCLUSIONS
Early discharge following major liver resection using a 'fast-track' recovery protocol is both safe and achievable.
MacKay
G
G
University Department of Surgery, Western Infirmary, Glasgow G11 0NT. drgjmac@hotmail.com
O'Dwyer
P J
PJ
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011183:Postoperative Complications; D011446:Prospective Studies