title: Impact of fast-track postoperative care on intestinal function, pain, and length of hospital stay after laparoscopic radical prostatectomy.
abstract: OBJECTIVE
  Postoperative recovery of intestinal function, ability to ambulate, and effective pain management are main features to establish an effective fast-track surgery model. We investigated pain scores, ambulation rate, and recovery of intestinal function in a cohort of patients who were undergoing laparoscopic radical prostatectomy (LRP).
  
  
  METHODS
  Fifty patients who underwent LRP in our institution were randomized to receive either conventional or fast-track postoperative care. Postoperative intestinal function was quantified by clinical signs of intestinal motility. Ambulation data were collected by means of step-count devices. Pain scores were measured by a visual analog scale. Overall satisfaction and additional measures to describe patient satisfaction with the clinical course were used as quality-of-life variables.
  
  
  RESULTS
  Fast-track patients had significantly earlier propulsive intestinal motility without increased intestinal complications. Enforced mobilization led to a significantly shorter period to first deflation/defecation. Despite significantly increased ambulation rates in the fast-track group, these patients reported significantly less pain sentience during a significantly shorter hospital stay. Overall satisfaction was significantly higher in the fast-track cohort during the hospital stay.
  
  
  CONCLUSIONS
  With the implementation of fast-track concepts for LRP, patients can be discharged to home earlier with fewer complications, lower pain scores, and an overall higher satisfaction with life.
authors: Department of Urology, Charité University Medicine, Campus Mitte, Berlin, Germany. amagheli@gmail.com
authors: Ahmed
authors: A
authors: Magheli
authors: Nina
authors: N
authors: Knoll
authors: Michael
authors: M
authors: Lein
authors: Stefan
authors: S
authors: Hinz
authors: Carsten
authors: C
authors: Kempkensteffen
authors: Oliver
authors: O
authors: Gralla
mesh_terms: D006761:Hospitals; D006801:Humans; D007422:Intestines / Q000503:physiopathology*; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology*; D017060:Patient Satisfaction; D011182:Postoperative Care; D011468:Prostatectomy / Q000009:adverse effects*