title: Current perioperative practice in rectal surgery in Austria and Germany.
abstract: OBJECTIVE
  'Fast-track' rehabilitation is able to accelerate recovery, reduce general morbidity, and decrease hospital stay. This is widely accepted for colonic resections. Despite recent evidence that fast track concepts are safe and feasible in rectal resection, there is no information on the acceptance and utilization of these concepts among Austrian and German surgeons.
  
  
  METHODS
  A questionnaire concerning perioperative routines in elective, open rectal resection was sent to the chief surgeons of 1,270 German and 120 Austrian surgical centers.
  
  
  RESULTS
  The response rate was 63% in Austria (76 centers) and 30% in Germany (385 centers). Mechanical bowel preparation is only abandoned by 2% of the Germany and 7% of the Austrian surgeons. Nasogastric decompression tubes are rarely used; four of five of the questioned surgeons in both countries use intra-abdominal drains. Half of the surgical centers allow the intake of clear fluids on the day of surgery. Mobilization starts in half of the centers on the day of surgery. Epidural analgesia is used in three-fourths of the institutions. Institutions which have implemented fast track rehabilitation for rectal resections discharge the patients earlier then hospitals that adhere to traditional care.
  
  
  CONCLUSIONS
  In many perioperative procedures, Austrian and German Surgeons rely on their traditional approaches. Recent evidence-based adaptations of perioperative routines in rectal resections are only slowly introduced into daily routine; therefore, further efforts have to be done to optimizing patients' care.
authors.affiliation: Department of Surgery, University Hospital Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany. till.hasenberg@umm.de
authors.forename: Till
authors.initials: T
authors.lastname: Hasenberg
authors.forename: Friedrich
authors.initials: F
authors.lastname: Längle
authors.forename: Bianca
authors.initials: B
authors.lastname: Reibenwein
authors.forename: Karin
authors.initials: K
authors.lastname: Schindler
authors.forename: Stefan
authors.initials: S
authors.lastname: Post
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schwenk
authors.forename: Edward
authors.initials: E
authors.lastname: Shang
mesh_terms: D001317:Austria; D013505:Digestive System Surgical Procedures / Q000639:trends*; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D007430:Intraoperative Care; D010351:Patient Discharge; D019990:Perioperative Care; D012007:Rectum / Q000601:surgery*; D011795:Surveys and Questionnaires