“Fast-track” rehabilitation after colonic surgery in elderly patients—is it feasible?
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Background and aims
The aim of the “fast-track” rehabilitation after elective colonic surgery is to lower the extent of general complications. Elderly patients may especially profit from this multi-modal peri-operative treatment including enforced early mobilisation and oral nutrition.
Materials and methods
In this prospective study using a well-defined post-operative multi-modal treatment programme, we examined the feasibility of this so-called fast-track rehabilitation in elderly patients. The programme employed combined thoracic peri-dural analgesia, early enforced mobilisation and rapid oral nutrition.
Seventy-four consecutive patients older than 70 years with benign or malignant disease of the large intestine were operated on. All patients were treated peri-operatively using the “fast-track” rehabilitation programme. Of the patients, 84% were able to have liquids orally on the day of surgery and 86% had solid food on the 1st post-operative day. The median time until the first bowel movement was 2 days. Only 12 (16%) patients had a total of 16 local complications, including 2 (3%) patients with anastomotic leakages. Nine patients (12%) had a total of 14 general complications; mortality rate was 1% (n = 1). Patients were discharged from the hospital 5 (5th–95th percentile = 4–6 days) days after surgery.
Using the “fast-track” rehabilitation programme on elderly patient is not only feasible but may also lower the number of general complications and the duration of the hospital stay.
Keywords“Fast-track” rehabilitation Elderly patients Post-operative complications Peri-operative treatment
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