BACKGROUND/AIMS: Fast track (IT) rehabilitation programmes have demonstrated advantages over traditional perioperative care after open colonic surgery; however. their contribution in recovery after laparoscopic colonic surgery is not clearly defined. This study was conducted to estimate the value of FT rehabilitation programme in laparoscopic colonic resections. METHODOLOGY: This is a randomized prospective controlled clinical trial. Ninety-nine consecutive patients underwentelective laparoscopic colonic resection between February 2008 and March 2009. Forty-nine patients received FT multimodal rehabilitation programme as FT group and 50 patients underwent traditional perioperative care as non-FT group. Postoperative hospital stay, return of gastrointestinal function, postoperative complications were recorded. RESULTS:Postoperative hospital stay was shorter in the FT group, a median duration of 4.0 days versus 5.0 days in the non-FT group (p<0.01). Gastrointestinal functional recovery occurred 1 day earlier in FT group (passage of flatus after 2.0 days vs. 3.0 days, p<0.01). There were no significant differences in complications within 30 postoperative days (12% in FT group vs. 20% in non-FT group, p=0.295). CONCLUSIONS: When applied after laparoscopic colonic surgery, FT rehabilitation programme is feasible, safe and may lead to accelerated functional recovery and reductions in postoperative hospital stay.
RCT Entities:
BACKGROUND/AIMS: Fast track (IT) rehabilitation programmes have demonstrated advantages over traditional perioperative care after open colonic surgery; however. their contribution in recovery after laparoscopic colonic surgery is not clearly defined. This study was conducted to estimate the value of FT rehabilitation programme in laparoscopic colonic resections. METHODOLOGY: This is a randomized prospective controlled clinical trial. Ninety-nine consecutive patients underwent elective laparoscopic colonic resection between February 2008 and March 2009. Forty-nine patients received FT multimodal rehabilitation programme as FT group and 50 patients underwent traditional perioperative care as non-FT group. Postoperative hospital stay, return of gastrointestinal function, postoperative complications were recorded. RESULTS: Postoperative hospital stay was shorter in the FT group, a median duration of 4.0 days versus 5.0 days in the non-FT group (p<0.01). Gastrointestinal functional recovery occurred 1 day earlier in FT group (passage of flatus after 2.0 days vs. 3.0 days, p<0.01). There were no significant differences in complications within 30 postoperative days (12% in FT group vs. 20% in non-FT group, p=0.295). CONCLUSIONS: When applied after laparoscopic colonic surgery, FT rehabilitation programme is feasible, safe and may lead to accelerated functional recovery and reductions in postoperative hospital stay.
Authors: Massimiliano Greco; Giovanni Capretti; Luigi Beretta; Marco Gemma; Nicolò Pecorelli; Marco Braga Journal: World J Surg Date: 2014-06 Impact factor: 3.352