International Journal of Colorectal Disease

, Volume 23, Issue 1, pp 93–99

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

  • 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
Original Article

DOI: 10.1007/s00384-007-0374-z

Cite this article as:
Schwenk, W., Günther, N., Wendling, P. et al. Int J Colorectal Dis (2008) 23: 93. doi:10.1007/s00384-007-0374-z

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.

Keywords

Colonic resection Peri-operative treatment Multi-modal therapy Morbidity Hospital stay Fast-track 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • W. Schwenk
    • 1
  • N. Günther
    • 1
  • P. Wendling
    • 2
  • M. Schmid
    • 3
  • W. Probst
    • 4
  • K. Kipfmüller
    • 5
  • B. Rumstadt
    • 6
  • M. K. Walz
    • 7
  • R. Engemann
    • 8
  • T. Junghans
    • 1
  • “Fast-track” Colon II Quality Assurance Group
  1. 1.General-, Visceral-, Vascular- and Thoracic Surgery, Charité Campus MitteUniversitymedicine BerlinBerlinGermany
  2. 2.Chirurgische Klinik I, Krankenhaus Bad SodenKliniken des Main-Taunus-Kreises GmbHBad SodenGermany
  3. 3.Klinik für Allgemein- und ViszeralchirurgieWestpfalz-Klinikum GmbH Standort III KirchheimbolandenKirchheimbolandenGermany
  4. 4.Klinik für Allgemein- und ViszeralchirurgieAmmerland Klinik GmbHWesterstedeGermany
  5. 5.Klinik für Allgemein- und ViszeralchirurgieSankt-Marien HospitalMülheim an der RuhrGermany
  6. 6.Klinik für Allgemein- und ViszeralchirurgieDiakoniekrankenhaus MannheimMannheimGermany
  7. 7.Klinik für Chirurgie und Zentrum für Minimal Invasive ChirurgieKlinikum Essen MitteEssenGermany
  8. 8.Chirurgische Klinik I Allgemein-, Viszeral- und GefäßchirurgieKlinikum AschaffenburgAschaffenburgGermany

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