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Fast-track concepts in routine pediatric surgery: a prospective study in 436 infants and children

Langenbeck's Archives of Surgery volume 394, pages 529–533 (2009)Cite this article

Abstract

Background and aims

The aim of this study was to investigate fast-track concepts in routine pediatric surgery in a university clinic over 1 year.

Patients/methods

Fast-track concepts were established for procedures requiring hospital admission in patients up to 15 years of age. Patients were studied prospectively from June 2006 to June 2007.

Results

Out of a total of 436 potentially suitable patients, 155 (36%) were finally treated following the protocols. The mean intensity of pain in children younger than 4 years (CHIPPS, 0–10) was 1.3 ± 1.5 the evening of the operation day and decreased to <1 at all other time points. The initial postoperative mean pain intensity in older children (Smiley/VAS, 1–10) was 3.7 ± 2.2 and decreased constantly thereafter. The mean hospital stay of fast-track patients was significantly shorter compared with German diagnosis-related group data (4.6 ± 2.9 versus 9.7 ± 3.8, p < 0.01). There were four (3%) readmissions for minor complications. At follow-up after 2 weeks, 95% of patients and parents judged fast-track care as excellent.

Conclusion

Fast-track concepts are feasible in one third of pediatric patients undergoing routine in-hospital surgery. Fast-track pediatric surgery achieves accelerated convalescence, minimal hospital stay, and high patient and parent satisfaction.

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Author information

Affiliations

  1. Department of Pediatric Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Marc Reismann, Jens Dingemann, Mathias Wolters, Birgit Laupichler & Benno M. Ure

  2. Department of Anesthesiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Robert Suempelmann

Authors
  1. Marc Reismann
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  2. Jens Dingemann
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  3. Mathias Wolters
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  4. Birgit Laupichler
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  5. Robert Suempelmann
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  6. Benno M. Ure
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Corresponding author

Correspondence to Marc Reismann.

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Reismann, M., Dingemann, J., Wolters, M. et al. Fast-track concepts in routine pediatric surgery: a prospective study in 436 infants and children. Langenbecks Arch Surg 394, 529–533 (2009). https://doi.org/10.1007/s00423-008-0440-1

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  • DOI: https://doi.org/10.1007/s00423-008-0440-1

Keywords

  • Fast-track surgery
  • Children