Implementing fast-track protocol for colorectal surgery: a prospective randomized clinical trial.
BACKGROUND
Fast-track protocols are followed by an enhanced recovery, early return to bowel function and to complete nutrition, and a reduced hospital stay. Our study was designed to implement fast-track protocol in our university hospital.


METHODS
The 96 consecutive patients with colorectal neoplasm included in the study were randomized in two equal groups: group 1 (FT) included patients undergoing colorectal surgery in a fast-track protocol, and group 2 (C) included patients undergoing colorectal surgery with a conventional care protocol. As with other fast-track protocols, our protocol included carbohydrate fluids load before operation, early mobilization and oral feeding, regular prokinetics, and multimodal postoperative analgesia. Time to restoration of bowel function, to complete mobilization and feeding, length of hospital stay, and incidence of complications and readmissions were monitored.


RESULTS
Time to mobilization, restoring of bowel function, and complete oral feeding were significantly shorter with fast-track protocol (p = 0.001, p = 0.042, and p = 0.01, respectively). Hospital stay also was shorter in the fast-track group (p = 0.001). The incidence of complications did not significantly differ with the study groups.


CONCLUSIONS
In our study, fast-track protocol resulted in a shorter time to mobilization, complete feeding, and discharge from hospital. Fast-track protocol did not increase the incidence of complications. However, we consider that our data require further confirmation with powered multicenter national studies.
Ionescu
Daniela
D
Department of Anesthesia and Intensive Care, University of Medicine and Pharmacy, Iuliu Hatieganu, Cluj-Napoca, Romania. dionescuati@yahoo.com
Iancu
Cornel
C
Ion
Daniela
D
Al-Hajjar
Nadim
N
Margarit
Simona
S
Mocan
Lucian
L
Mocan
Teodora
T
Deac
Delia
D
Bodea
Raluca
R
Vasian
Horatiu
H
D000368:Aged; D002985:Clinical Protocols; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D013997:Time Factors
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