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Fast-Track Program Offers Benefits After Colon Surgery

Protocol with restricted fluids, faster oral nutrition linked to fewer complications, shorter stay

THURSDAY, Mar. 12 (HealthDay News) -- A fast-track protocol for patients undergoing elective colon surgery was linked to lower morbidity and a shorter hospital stay, according to research published in the March issue of Gastroenterology.

Sven Muller, M.D., of the University Hospital in Zurich, Switzerland, and colleagues analyzed data from 151 adults undergoing elective open colonic resection with primary anastomosis who were randomized to standard care or a fast-track program. The latter included perioperative fluid restriction and early postoperative oral feeding.

Complications within 30 days after surgery were significantly lower in the fast-track group (16 of 76 patients) versus the standard-care group (37 of 75 patients), the researchers report. The fast-track group also had a shorter hospital stay (median five days versus nine days). Intraoperative fluid restriction and effective epidural anesthesia were found to be predictors of reduced complications after the procedure, the report indicates.

"A major concern about fast-track programs with early discharge may be the risk of missing severe postoperative complications," the authors write. "In the present study the re-admission rate was low and similar between the two groups. Furthermore, patients were observed for up to 30 days postoperatively, which considerably lessens the risk of missing a complication. In patients in fast-track programs with a slightly prolonged minimal hospital stay of up to three days [in earlier research], no higher re-admission rates were observed."

Several co-authors have received research support from Fresenius Kabi.

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