Colonic Surgery with Accelerated Rehabilitation or Conventional Care

Linda Basse, Jens Erik Thorbøl, Kristine Løssl, Henrik Kehlet, Anthony Senagore

Research output: Contribution to journalArticlepeer-review

356 Scopus citations

Abstract

BACKGROUND: For patients undergoing colonic surgery, the postoperative hospital stay is usually 6 to 10 days, and the morbidity rate is 15 to 20 percent. Fast-track rehabilitation programs have reduced the hospital stay to 2 to 3 days. The aim of this study was to evaluate the postoperative outcome after colonic resection with conventional care compared with fast-track multimodal rehabilitation. METHODS: One hundred thirty consecutive patients receiving conventional care (group 1) in one hospital were compared with 130 consecutive patients receiving multimodal, fast-track rehabilitation (group 2) in another hospital. Outcomes were time to first defecation after surgery, postoperative hospital stay, and morbidity during the first postoperative month. RESULTS: Median age was 74 years (group 1) and 72 years (group 2). American Society of Anesthesiologists (ASA) score was significantly higher in group 2 (P < 0.05). Defecation occurred on day 4.5 in group 1 and day 2 in group 2 (P < 0.05). Median hospital stay was 8 days in group 1 and 2 days in group 2 (P < 0.05). The use of a nasogastric tube was longer in group 1 (P < 0.05). The overall complication rate (35 patients) was lower in group 2 (P < 0.05), especially cardiopulmonary complications (5 patients; P < 0.01). Readmission was necessary in 12 percent of cases for group 1 and 20 percent in group 2 (P > 0.05). CONCLUSIONS: Time to first defecation, hospital stay, and morbidity may be reduced after colonic resection with fast-track multimodal rehabilitation.

Original languageEnglish (US)
Pages (from-to)271-278
Number of pages8
JournalDiseases of the Colon and Rectum
Volume47
Issue number3
DOIs
StatePublished - Mar 2004
Externally publishedYes

Keywords

  • Fast track
  • Morbidity
  • Postoperative
  • Rehabilitation
  • Surgery

ASJC Scopus subject areas

  • Gastroenterology

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