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Effectiveness of fast‐track rehabilitation vs conventional care in laparoscopic colorectal resection for elderly patients: a randomized trial
Author(s) -
Wang Q.,
Suo J.,
Jiang J.,
Wang C.,
Zhao Y.Q.,
Cao X.
Publication year - 2012
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2011.02855.x
Subject(s) - medicine , fast track , randomized controlled trial , colorectal cancer , perioperative , gastrointestinal function , rehabilitation , surgery , gastrointestinal cancer , laparoscopy , physical therapy , cancer
Aim The aim of the study was to evaluate the efficacy and safety of fast‐track rehabilitation in elderly patients over 65 years of age, following laparoscopic surgery to remove colorectal cancer. Method A total of 78 elderly patients with colorectal cancer who underwent laparoscopic colorectal resection were randomly assigned to receive either the fast‐track care programme ( n = 40) or the conventional perioperative care protocol (control group, n = 38). Medical personnel conducting the study were blinded to patients’ clinical outcomes prior to statistical analysis. The fast‐track protocol included no preoperative mechanical bowel irrigation, immediate oral alimentation and earlier postoperative ambulation exercise. The length of postoperative hospital stay, the length of time to regain bowel function and the rate of postoperative complications were compared between the two groups. Results The length of time to regain bowel function, including the passage of flatus[31 (26–40) h vs 38 (32–51) h, P = 0.001], to the first bowel movement [55 (48–63) h vs 64 (48–71) h, P = 0.009] and to start a liquid diet (12 [11–16] h vs 47 [35–50] h, P = 0.000) were significantly shorter in patients receiving the fast‐track care protocol compared with those receiving the conventional care protocol. A shorter duration of postoperative hospital stay was recorded in patients receiving the fast‐track program than in those receiving conventional care ( P = 0.0001). A reduced percentage of patients who developed general complications was also observed in the fast‐track group (5.0% v s 21.1%, P = 0.045). Conclusion This randomized controlled trial has shown that in the elderly undergoing laparoscopic colorectal surgery, the fast‐track recovery programme resulted in a more rapid postoperative recovery, earlier discharge from hospital and fewer general complications compared with a conventional postoperative protocol.