title: Fast track postoperative management after elective colorectal surgery: a controlled trail.
abstract: In the attempt to reduce postoperative complications and costs and improve outcomes, the concept of fast track surgery has been proposed. Improvements in anesthesia techniques and a better understanding of the pathophysiologic events occurring during and after surgery have made it possible. A group of patients undergoing colorectal resections with a fast track approach were investigated; specifically, the effects on postoperative morbidity, resumption of intestinal function, and duration of hospitalization. Fifty patients were managed according to a protocol, which included epidural analgesia, early ambulation, and oral feeding (fast track group); they were compared with 50 patients managed with a different protocol: no epidural analgesia, early ambulation, and early oral diet (control group). Primary outcome end-points reported include morbidity, time to passage of flatus and stool, and length of hospital stay. Fourteen complications occurred in the fast track group and 13 in the control group (P = not significant (NS)). Resumption of intestinal function occurred after 3 days, and length of hospital stay was 5 days in the fast track group compared with 4 and 7 days respectively in control patients (P = NS, P < 0.01). Patients undergoing elective colorectal resections can be managed safely with fast track protocols reducing hospital stay.
authors.affiliation: Department of Surgery, Anesthesiology, and Radiology, University of Ferrara, Ferrara, Italy. cvfeo@unife.it
authors.forename: Carlo V
authors.initials: CV
authors.lastname: Feo
authors.forename: Serena
authors.initials: S
authors.lastname: Lanzara
authors.forename: Davide
authors.initials: D
authors.lastname: Sortini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ragazzi
authors.forename: Mario
authors.initials: M
authors.lastname: De Pinto
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Pansini
authors.forename: Alberto
authors.initials: A
authors.lastname: Liboni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000601:surgery; D004434:Early Ambulation; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care / Q000379:methods*; D020127:Recovery of Function