Multimodal perioperative rehabilitation in elective conventional resection of colonic cancer: results from the German Multicenter Quality Assurance Program 'Fast-Track Colon II'.
OBJECTIVE
Multimodal perioperative rehabilitation in patients undergoing curative conventional colonic resection for cancer has not yet been studied in a multicenter setting. In 2005, a nationwide quality assurance program was initiated in Germany in an unselected patient population.


METHODS
The prospective multicenter data collection includes patients from 24 German hospitals. All hospitals had established 'fast-track' rehabilitation as the standard perioperative treatment in elective colonic resection, and all patients entered the registry.


RESULTS
748 of 2,047 fast-track patients (36.5%) underwent open resection of colonic cancer. The median age of the 380 female and 368 male patients was 71 (26-96) years. Compliance was high for epidural analgesia (89%), systemic basic nonopioid analgesia (93%), 'restrictive' intraoperative intravenous fluids (81%), oral feeding (73%) and enforced mobilization (84%) on the day of surgery. Surgical complications were diagnosed in 20%, general morbidity occurred in only 13% of all patients, and 3 patients (0.4%) died in the early postoperative period. Readmission within 30 days of discharge was necessary in 27 patients (4%).


CONCLUSIONS
Compliance with fast-track measures was high, and general morbidity was low in a population of patients undergoing multimodal perioperative rehabilitation for conventional colonic cancer resection.
Braumann
Chris
C
Department of General, Visceral, Vascular and Thoracic Surgery, Charité - University of Medicine, Berlin, Germany. chris.braumann@charite.de
Guenther
Nina
N
Wendling
Peter
P
Engemann
Rainer
R
Germer
Christoph T
CT
Probst
Wolfgang
W
Mayer
Hans-P
HP
Rehnisch
Bernd
B
Schmid
Michael
M
Nagel
Klaus
K
Schwenk
Wolfgang
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000534:rehabilitation* / Q000592:standards; D003110:Colonic Neoplasms / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000534:rehabilitation / Q000592:standards; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012042:Registries