A prospective study on the influence of a fast-track program on postoperative fatigue and functional recovery after major colonic surgery.
BACKGROUND
Enhanced Recovery After Surgery (ERAS) programs have demonstrated significant reduction in hospital stay for patients undergoing colonic surgery; however, their impact on long-term outcomes, such as postoperative fatigue (POF), has not been fully established.


OBJECTIVE
To assess the impact of an ERAS program on POF and recovery following elective open colonic surgery.


METHODS
In a prospective study, 26 consecutive patients undergoing open colonic surgery under a conventional care plan were compared with 26 consecutive patients in an ERAS program.


RESULTS
Demographic and clinical characteristics were comparable at baseline. The median duration of total hospital stay (4 versus 7 d, P < 0.001), rates of urinary tract infections (P = 0.028) and ileus (P = 0.042) were significantly smaller in the ERAS group. Postoperatively, POF significantly increased in both groups. However, peak POF score was significantly lower in the ERAS group (P = 0.001). In the first 30 d after surgery, Fatigue Consequence scores were also significantly smaller in the ERAS group. Overall, the total fatigue experience (P = 0.035) and the total fatigue impact (P = 0.005) were significantly smaller in the ERAS group.


CONCLUSIONS
The impact of ERAS programs may extend beyond the commonly reported short-term outcomes, and ERAS may accelerate overall recovery and return to normal function.
Zargar-Shoshtari
Kamran
K
South Auckland Clinical School of Medicine, Middlemore Hospital, Auckland, New Zealand.
Paddison
Johanna S
JS
Booth
Roger J
RJ
Hill
Andrew G
AG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000534:rehabilitation* / Q000601:surgery*; D005221:Fatigue / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000534:rehabilitation*; D011446:Prospective Studies; D020127:Recovery of Function