Convalescence after colonic surgery with fast-track vs conventional care.

Abstract

OBJECTIVE:

To compare convalescence after colonic surgery with a fast-track rehabilitation programme vs conventional care.

BACKGROUND:

Introduction of a multimodal rehabilitation programme (fast-track) with focus on epidural anaesthesia, minimal invasive surgical techniques, optimal pain control, and early nutrition and mobilization together with detailed patient information have led to a shorter hospital stay after colonic surgery. There are not much data on convalescence after discharge.

METHODS:

A prospective, controlled, non-randomized interview-based assessment in 160 patients undergoing an elective, uncomplicated, open colonic resection or the Hartmann reversal procedure with a fast-track or a conventional care programme in two university hospitals. A structured interview-based assessment was performed preoperatively, and day 14 and 30 postoperatively.

RESULTS:

Patients undergoing colonic surgery with a fast-track programme regained functional capabilities earlier with less fatigue and need for sleep compared with patients having conventional care. Despite early discharge of the fast-track patients (mean 3.4 days vs 7.5 days), no differences were found according to the need for home care, social care and visit to general practitioners, although the fast-track group had an increased number of visits at the outpatient clinic for wound care. More patients in the fast-track group were re-admitted, but the overall mean total hospital stay was 4.2 days vs 8.3 days in the conventional group.

CONCLUSION:

A fast-track rehabillitation programme led to a shorter hospital stay, less fatigue and earlier resumption of normal activities, without the increased need for support after discharge compared with conventionally treated patients after uncomplicated colonic resection.

• Authors: D H Jakobsen, E Sonne, J Andreasen, H Kehlet
• Journal: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland (Colorectal Dis) Vol. 8 Issue 8 Pg. 683-7 (Oct 2006) ISSN: 1462-8910 [Print] England
• PMID: 16970579 (Publication Type: Comparative Study, Journal Article)

Topics

• Aged
• Anastomosis, Surgical (rehabilitation)
• Colorectal Surgery (rehabilitation)
• Convalescence
• Female
• Humans
• Interviews as Topic
• Male
• Prospective Studies
• Time Factors
• Treatment Outcome