Fast track postoperative management for patients undergoing elective colorectal resections: A controlled trial.

In the attempt to reduce postoperative complications and costs and improve outcomes the concept of fast track surgery has been proposed. Improvements in anaesthesia techniques and a better understanding of the pathophysiologic events occurring during and after surgery have made it possible. A group of patients undergoing colorectal resections with a fast track approach were investigated; specifically, the effects on postoperative morbidity, resumption of intestinal function, and duration of hospitalization. Fifty patients were managed according to a protocol which included epidural analgesia, early ambulation, and oral feeding (fast track group); they were compared to 50 patients managed with a different protocol: no epidural analgesia and early ambulation, early oral diet (control group). Primary outcome end-points reported include morbidity, time to passage of flatus and stool, and length of hospital stay. Fourteen complications occurred in the fast track group and 13 in the control group (P = NS). Resumption of intestinal function occurred after 3 days, and length of hospital stay was 5 days in the fast track group compared to 4 and 7 days respectively in control patients (P = NS, P < 0.01). Patients undergoing elective colorectal resections can be managed safely with fast track protocols reducing hospital stay.