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01.01.2008 | Original Article | Ausgabe 1/2008

International Journal of Colorectal Disease 1/2008

“Fast-track” rehabilitation for elective colonic surgery in Germany—prospective observational data from a multi-centre quality assurance programme

Zeitschrift:
International Journal of Colorectal Disease > Ausgabe 1/2008
Autoren:
W. Schwenk, N. Günther, P. Wendling, M. Schmid, W. Probst, K. Kipfmüller, B. Rumstadt, M. K. Walz, R. Engemann, T. Junghans, “Fast-track” Colon II Quality Assurance Group
Wichtige Hinweise
A complete list of all centres contributing patients to the “Fast-track” Colon II-Quality Assurance programme is given at the end of the manuscript.

Abstract

Background

The results of “Fast-track” colonic surgery in an unselected population outside of specialised units has been unknown yet.

Materials and methods

Data from 24 German hospitals performing “Fast-track” rehabilitation as the standard peri-operative care for patients undergoing elective colonic resection were collected in a prospective multi-centre study conducted between April 2005 and September 2006 to evaluate local and general morbidity.

Results

One thousand and forty-seven patients undergoing elective “fast-track” colonic resection were included. Compliance to essential parts of “fast-track” rehabilitation was high (epidural analgesia 86,6%, early oral feeding and mobilisation on the day of surgery 85.5 and 85.4%). Surgical morbidity was observed in 148 patients (14.1%) and general morbidity in 95 patients (9.1%), while mortality was 0.8%. Predefined discharge criteria were met within 5 (1–83) days after surgery, but because of economical restraints in the German DRG system, patients were discharged only after 8 (3–83) days. Re-admission rate was 3.9%.

Conclusion

“Fast-track” rehabilitation for elective colonic resection was safe and feasible in German hospitals of all sizes and yielded a low general morbidity and re-admission rate. Post-operative recovery was enhanced, but discharge from hospital was delayed because of economical reasons.

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