title: Fast-track elective colectomy: single-surgeon experience of 100 consecutive cases.
abstract: OBJECTIVE
  In 2005, the senior author (AGH) initiated an Enhanced Recovery After Surgery (ERAS) or 'fast-track' programme for elective colonic surgery at the Manukau Surgery Centre aimed at improving perioperative care. We reviewed the senior author's experience of elective colectomy conducted within the ERAS programme and evaluated clinical outcomes.
  
  
  METHODS
  Using a prospectively maintained database, consecutive patients who underwent elective colonic resection by the senior author within the ERAS programme at the Manukau Surgery Centre between December 2005 and March 2012 were reviewed. Demographic and operative data were recorded and clinical outcomes including complications, hospital stay and readmissions were evaluated for 30 days postoperatively.
  
  
  RESULTS
  100 consecutive patients were reviewed. The median age of patients was 70 years (range: 16-92) and the most common indication for surgery was malignancy (81 cases). Right-sided colectomy was performed in 52 cases while 45 patients had a left-sided colectomy and 3 patients underwent subtotal colectomy. The median day to discharge was 3 days while total hospital stay was 4 days which incorporated 21 readmissions for mostly minor complications. Major complications occurred in only 8 patients and included 4 anastomotic leaks.
  
  
  CONCLUSIONS
  In one surgeon's experience, elective colectomy performed within an optimised perioperative care environment achieves shorter hospital stay with a low rate of major complications.
authors: Department of Surgery, South Auckland Clinical School, University of Auckland, Private Bag 93311, Middlemore Hospital, Otahuhu, Auckland 1640, New Zealand. dr.parrysingh@gmail.com
authors: Primal P
authors: PP
authors: Singh
authors: Andrew G
authors: AG
authors: Hill
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000706:statistics & numerical data*; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D019990:Perioperative Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult