Literature DB >> 24435243

Observational cross-sectional study of compliance with the fast track protocol in elective surgery for colon cancer in Spain.

Manuel Alcántara-Moral1, X Serra-Aracil, M J Gil-Egea, M Frasson, B Flor-Lorente, E Garcia-Granero.   

Abstract

PURPOSE: The purpose of this study was to establish the degree of compliance with the fast track (enhanced recovery) protocol in habitual clinical practice and to determine which measures are fundamental for achieving the results obtained by applying the entire protocol.
METHODS: Observational, cross-sectional, multicenter trial was conducted. Participating hospitals prospectively recorded data from at least ten consecutive patients undergoing surgery for colon cancer who were applied some or all of the items comprising the enhanced recovery protocol. The data were analyzed both globally and dividing the sample into the two groups of patients.
RESULTS: Data on 363 patients from 25 hospitals were recorded, one hundred seventy-three in the "non-fast track" group and 190 in the "fast track" group. The non-fast track group complied with a mean of 5.4 (±1.8) items and the fast track group with a mean of 8.4 (±1.8) items. The mean functional hospital stay was 7.3 (±5.1) days in the non-fast track group and 6.2 (±5.1) days in the fast track group (p < 0.05). Morbidity was 31.1 % in the fast track group and 24.3 % in the non-fast track group, though the differences were not statistically significant. The only prognostic factors that have an impact on improving the results are measures against hypothermia and mobilization before 24 h.
CONCLUSION: Compliance with the enhanced recovery protocol is not exhaustive in habitual clinical practice. However, greater compliance was associated with shorter hospital stay without any increase in morbidity. The only items clearly associated with reduced functional hospital stay were measures against hypothermia and mobilization before 24 h.

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Year:  2014        PMID: 24435243     DOI: 10.1007/s00384-013-1825-3

Source DB:  PubMed          Journal:  Int J Colorectal Dis        ISSN: 0179-1958            Impact factor:   2.571


  17 in total

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Review 2.  Enhanced recovery after surgery protocols - compliance and variations in practice during routine colorectal surgery.

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Journal:  Colorectal Dis       Date:  2012-09       Impact factor: 3.788

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4.  A protocol is not enough to implement an enhanced recovery programme for colorectal resection.

Authors:  J Maessen; C H C Dejong; J Hausel; J Nygren; K Lassen; J Andersen; A G H Kessels; A Revhaug; H Kehlet; O Ljungqvist; K C H Fearon; M F von Meyenfeldt
Journal:  Br J Surg       Date:  2007-02       Impact factor: 6.939

Review 5.  Enhanced recovery in colorectal resections: a systematic review and meta-analysis.

Authors:  C J Walter; J Collin; J C Dumville; P J Drew; J R Monson
Journal:  Colorectal Dis       Date:  2009-02-04       Impact factor: 3.788

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8.  Enhanced recovery pathways optimize health outcomes and resource utilization: a meta-analysis of randomized controlled trials in colorectal surgery.

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9.  [Multimodal (fast-track) rehabilitation in elective colorectal surgery: evaluation of the learning curve with 300 patients].

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Authors:  Rebecca K Marcus; Heather A Lillemoe; David C Rice; Gabriel Mena; Brian K Bednarski; Barbra B Speer; Pedro T Ramirez; Javier D Lasala; Neema Navai; Wendell H Williams; Bradford J Kim; Rachel K Voss; Vijaya N Gottumukkala; Thomas A Aloia
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Review 5.  Incomplete reporting of enhanced recovery elements and its impact on achieving quality improvement.

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8.  A Breakthrough Improvement Collaborative Significantly Reduces Hospital Stay After Elective Colectomy for Cancer Across a Healthcare System.

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9.  Intraoperative Goal-directed Fluid Therapy in Elective Major Abdominal Surgery: A Meta-analysis of Randomized Controlled Trials.

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