title: Feasibility of enhanced recovery programme in various patient groups.
abstract: BACKGROUND
  An accelerated multi-modal rehabilitation programme may improve the recuperation and reduce the complication rate in patients undergoing colorectal surgery. The aim of this study was to see whether fast-track recovery is feasible in various patient groups.
  
  
  METHODS
  Data on all patients operated for intestinal pathology from July 2006-April 2008 were prospectively collected for this prospective study. All included patients entered a multi-modal rehabilitation programme. Peri- and postoperative complications and readmissions, pathology reports and operation characteristics were recorded prospectively.
  
  
  RESULTS
  Three hundred and forty-eight patients underwent colorectal surgery. No difference in readmission rate was found between various patient groups. The only significant differences after multivariate regression analysis were in re-operation rate and length of stay in favour of the elective surgery group.
  
  
  CONCLUSIONS
  Fast-track modalities can be introduced with a low complication rate in all patient groups. Length of stay in elderly patients averages 10 days, implying that this group cannot be considered as "fast track", although the same protocol can also be applied in this group. Better organization of the aftercare might however considerably change the length of stay of elderly patients, since postoperative complications do not differ between old and young patients.
authors.affiliation: Department of General Surgery, Meander Medisch Centrum, Postbus 1502, 3500 BM, Amersfoort, The Netherlands. pmverheijen@gmail.com
authors.forename: Paul M
authors.initials: PM
authors.lastname: Verheijen
authors.forename: Anthony W H
authors.initials: AW
authors.lastname: Vd Ven
authors.forename: Paul H P
authors.initials: PH
authors.lastname: Davids
authors.forename: Bryan J M
authors.initials: BJ
authors.lastname: Vd Wall
authors.forename: Apollo
authors.initials: A
authors.lastname: Pronk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D020127:Recovery of Function / Q000502:physiology*; D012046:Rehabilitation; D012086:Reoperation
references.citation: BMJ. 2001 Feb 24;322(7284):473-6
references.pmid: 11222424
references.citation: Lancet. 2003 Dec 6;362(9399):1921-8
references.pmid: 14667752
references.citation: Ann Surg. 2000 Jul;232(1):51-7
references.pmid: 10862195
references.citation: Int J Colorectal Dis. 2011 Jun;26(6):747-53
references.pmid: 21286920
references.citation: J Am Coll Surg. 2006 Jan;202(1):45-54
references.pmid: 16377496
references.citation: Br J Surg. 2005 Nov;92(11):1354-62
references.pmid: 16237744
references.citation: Br J Surg. 2002 Apr;89(4):446-53
references.pmid: 11952586
references.citation: Int J Colorectal Dis. 2007 Dec;22(12):1469-74
references.pmid: 17483956
references.citation: Am J Surg. 2002 Jun;183(6):630-41
references.pmid: 12095591
references.citation: Dis Colon Rectum. 2003 Jul;46(7):851-9
references.pmid: 12847356
references.citation: Dis Colon Rectum. 2004 Mar;47(3):271-7; discussion 277-8
references.pmid: 14991487
references.citation: Br J Surg. 2003 Dec;90(12):1497-504
references.pmid: 14648727
references.citation: Scand J Surg. 2004;93(1):24-8
references.pmid: 15116815
references.citation: World J Surg. 2002 Jan;26(1):59-66
references.pmid: 11898035
references.citation: Clin Nutr. 2005 Jun;24(3):466-77
references.pmid: 15896435
references.citation: Br J Surg. 2006 Jul;93(7):800-9
references.pmid: 16775831
references.citation: Surg Endosc. 2004 Oct;18(10):1463-8
references.pmid: 15791370