Article (Scientific journals)
Insights into fast-track colon surgery: a plea for a tailored program.
Pellegrino, L.; Lois, Fernande; Remue, C. et al.
2013In Surgical Endoscopy, 27 (4), p. 1178-85
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Keywords :
Aged; Colectomy/methods/statistics & numerical data; Colonic Diseases/surgery; Female; Humans; Length of Stay/statistics & numerical data; Male; Middle Aged; Patient Care Planning; Retrospective Studies; Time Factors
Abstract :
[en] BACKGROUND: This retrospective study compared the fast-track colon surgery program to conventional perioperative care and assessed factors that influence postoperative length of stay. DESIGN: This retrospective study included 124 fast-track and 119 conventional care colon surgical patients. Exclusion criteria were primary rectal disease, stoma, American Society of Anesthesiologists score IV, and Association Francaise de Chirurgie index 3 or 4. Laparoscopy was the preferred approach. Variables influencing length of stay were analyzed by multivariate linear and logistic regression. RESULTS: Overall mortality and complication rates were not significantly different between groups (fast-track vs. controls 0 vs. 0.8 %, 30.6 vs. 38.6 % respectively). As expected, median length of stay was significantly reduced in fast-track patients (3 vs. 6 days, p < 0.001), but emergency readmission rate was higher (16.9 vs. 7.6 %, p = 0.026), although rehospitalization rates were similar (8 vs. 4.2 %, not significant). Independent risk factors of increased length of stay were identified as age >69 years (p = 0.001), laparotomy (p = 0.011), and conventional perioperative care (p < 0.001). CONCLUSIONS: The introduction of a fast-track program reduced postoperative length of stay without increasing complication rate. This study proposes a modulation of the program according to patient age and surgical approach.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Pellegrino, L.
Lois, Fernande ;  Cliniques Universitaires Saint-Luc (Bruxelles) > Service d'anesthésie - réanimation
Remue, C.
Forget, P.
Crispin, B.
Leonard, D.
Kartheuser, A.
Jamart, J.
Language :
English
Title :
Insights into fast-track colon surgery: a plea for a tailored program.
Publication date :
2013
Journal title :
Surgical Endoscopy
ISSN :
0930-2794
eISSN :
1432-2218
Publisher :
Springer, Germany
Volume :
27
Issue :
4
Pages :
1178-85
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 05 March 2017

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