Fast-Track Colonic Surgery: Status and Perspectives

  • Henrik Kehlet
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 165)

Abstract

Multi-modal rehabilitation with an emphasis on preoperative information, reduction of surgical stress responses, optimized dynamic pain relief with continuous epidural analgesia and early mobilization and oral nutrition may reduce hospital stay, morbidity, convalescence, and costs (fast-track surgery). Current results from fast-track colonic surgery suggest that postoperative pulmonary, cardiovascular, and muscle function are improved and body composition preserved as well as a normal oral intake of energy and protein can be achieved. Consequently, hospital stay is reduced to about 2–4 days, with decreased fatigue and need for sleep in the convalescence period. Despite a higher risk for readmissions, overall costs and morbidity seem to be reduced. Existing data from several institutions support the concept of fast-track colonic surgery to improve postoperative organ functions, thereby allowing for early rehabilitation with decreased hospital stay, convalescence, and costs. Further data are needed frommulti-national institutions on morbidity, safety, and costs.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2005

Authors and Affiliations

  • Henrik Kehlet
    • 1
  1. 1.Section for Surgical Pathophysiology, Rigshospitalet, Section 4074CopenhagenDenmark

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