title: Multimodal perioperative rehabilitation in elective conventional resection of colonic cancer: results from the German Multicenter Quality Assurance Program 'Fast-Track Colon II'.
abstract: 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.
authors.affiliation: Department of General, Visceral, Vascular and Thoracic Surgery, Charité - University of Medicine, Berlin, Germany. chris.braumann@charite.de
authors.forename: Chris
authors.initials: C
authors.lastname: Braumann
authors.forename: Nina
authors.initials: N
authors.lastname: Guenther
authors.forename: Peter
authors.initials: P
authors.lastname: Wendling
authors.forename: Rainer
authors.initials: R
authors.lastname: Engemann
authors.forename: Christoph T
authors.initials: CT
authors.lastname: Germer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Probst
authors.forename: Hans-P
authors.initials: HP
authors.lastname: Mayer
authors.forename: Bernd
authors.initials: B
authors.lastname: Rehnisch
authors.forename: Michael
authors.initials: M
authors.lastname: Schmid
authors.forename: Klaus
authors.initials: K
authors.lastname: Nagel
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schwenk
mesh_terms: 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