title: [Quality of life after fast track colorectal surgery].
abstract: BACKGROUND
  Fast track (enhanced recovery) surgery is a standardized concept of perioperative management, which is applied independently of the disease and the operative procedure. The implementation of this concept adjusts the quality of medical results and allows to analyse different factors and their impact on quality of life (QoL). The aim of this investigation was to assess the QoL of patients after elective colorectal surgery undergoing standardized perioperative fast track rehabilitation.
  
  
  METHODS
  From December 2004 to May 2006 all patients undergoing elective colorectal surgery and fast track rehabilitation were included in this study. Quality of life was evaluated prospectively using the Gastrointestinal Quality of Life Index (GIQLI) according to Eypasch. QoL was analyzed pre- and postoperatively. Subgroup analyses were performed regarding age, malignant or non-malignant colorectal disease and surgical approach. Follow-up was performed three months postoperatively.
  
  
  RESULTS
  124 patients underwent elective resection within a fast track program (age 64±10 years, 55 with benign disease, 69 with colorectal carcinoma; 67 men and 57 women). 62 patients (50 %) completed the follow-up examination (QoL evaluation three months postoperatively). Pre- and postoperative QoL did not differ significantly (98 [92-104] and 103 [98-109] points, respectively). Subgroup analyses revealed that patients having undergone colorectal resection for benign disease had significantly improved quality of life after surgery, but not so the patients treated for colorectal cancer. The QoL was 14 (2-26) and -1 (-9 - 5), respectively. Patients' age and surgical approach (minimally invasive or open) did not influence their QoL.
  
  
  CONCLUSIONS
  Postoperative QoL after standarized fast track perioperative management was influenced mainly by the patients' disease (with potential QoL improvement in benign disorders), whereas age and the operative approach (minimally invasive or open) had little impact in this respect.
authors.affiliation: Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäss- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg. kim_m@chirurgie.uniwuerzburg.de
authors.forename: M
authors.initials: M
authors.lastname: Kim
authors.forename: J
authors.initials: J
authors.lastname: Reibetanz
authors.forename: S
authors.initials: S
authors.lastname: Steinkirchner
authors.forename: B H A
authors.initials: BH
authors.lastname: von Rahden
authors.forename: C-T
authors.initials: CT
authors.lastname: Germer
authors.forename: C F
authors.initials: CF
authors.lastname: Jurowich
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural; D003108:Colonic Diseases / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D004434:Early Ambulation / Q000523:psychology; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D017060:Patient Satisfaction; D019990:Perioperative Care / Q000523:psychology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012002:Rectal Diseases / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D011795:Surveys and Questionnaires