title: Implementation of the fast track surgery in patients undergoing the colonic resection: own experience.
abstract: A perioperative care in the colorectal surgery has been considerably changed recently. The fast track surgery decreases complications rate, shortens length of stay, improves quality of life and leads to cost reduction. It is achieved by: resignation of a mechanical bowel preparation before and a nasogastric tube insertion after operation, optimal pain and intravenous fluid management, an early rehabilitation, enteral nutrition and removal of a vesical catheter and abdominal drain if used.The aim of the study was to compare the results of an implementation the fast track surgery protocol with results achieving in the conventional care regimen.Material and methods. Two groups of patients undergoing colonic resection have been compared. The study group was formed by patients treated with fast track concept, the control group - by patients who were dealt with hitherto regimen. Procedures needed stoma performing, rectal and laparoscopic surgery were excluded. The perioperative period was investigated by telephone call to patient or his family.Results. Statistical significant reduction was reached in a favour of the fast track group in the following parameters: the length of hospital stay (2.5 days shorter), duration of an abdominal cavity and vesicle drainage (3 and 2 days shorter respectively), postoperative day on which oral diet was implemented (2,5 days faster) and finally extended (1.5 days faster). There were no statistical difference in mortality, morbidity neither reoperation rate between two groups.Conclusion. The fast track surgery is a safe strategy and may improve a perioperative care.
authors.affiliation: Department of General, Gastroenterological and Oncological Surgery of the Central Public Clinical, Hospital Warsaw Medical University.
authors.forename: Daniel Antoni F
authors.initials: DA
authors.lastname: Morończyk
authors.forename: Ireneusz Wojciech
authors.initials: IW
authors.lastname: Krasnodębski
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002985:Clinical Protocols / Q000592:standards; D003108:Colonic Diseases / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery; D003107:Colorectal Surgery / Q000379:methods* / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D011044:Poland; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D017748:Time Management; D016896:Treatment Outcome