Multimodal Perioperative Rehabilitation in Elective Conventional Resection of Colonic Cancer: Results from the German Multicenter Quality Assurance Program ‘Fast-Track Colon II’Braumann C.a · Guenther N.a · Wendling P.b · Engemann R.c · Germer C.T.d · Probst W.e · Mayer H.-P.f · Rehnisch B.g · Schmid M.h · Nagel K.i · Schwenk W.a
aDepartment of General, Visceral, Vascular and Thoracic Surgery, Charité – University of Medicine, Berlin, bKliniken des Main-Taunus-Kreises GmbH, Bad Soden, cKlinikum Aschaffenburg, dKlinikum Nürnberg, eAmmerland Klinik GmbH, Westerstede, fHunsrück Klinik Kreuznacher Diakonie, Simmern, gKlinikum des Landkreises Löbau-Zittau gGmbH, Zittau, hWestpfalz-Klinikum GmbH, Standort III, Kirchheimbolanden, and iMarienhospital Aachen, Germany
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Article / Publication Details
Aim: Multimodal perioperative rehabilitation in patients undergoing curative conventional colonic resection for cancer has not yet been studied in a multicenter setting. In 2005, a nationwide quality assurance program was initiated in Germany in an unselected patient population. Methods: The prospective multicenter data collection includes patients from 24 German hospitals. All hospitals had established ‘fast-track’ rehabilitation as the standard perioperative treatment in elective colonic resection, and all patients entered the registry. Results: 748 of 2,047 fast-track patients (36.5%) underwent open resection of colonic cancer. The median age of the 380 female and 368 male patients was 71 (26–96) years. Compliance was high for epidural analgesia (89%), systemic basic nonopioid analgesia (93%), ‘restrictive’ intraoperative intravenous fluids (81%), oral feeding (73%) and enforced mobilization (84%) on the day of surgery. Surgical complications were diagnosed in 20%, general morbidity occurred in only 13% of all patients, and 3 patients (0.4%) died in the early postoperative period. Readmission within 30 days of discharge was necessary in 27 patients (4%). Conclusions: Compliance with fast-track measures was high, and general morbidity was low in a population of patients undergoing multimodal perioperative rehabilitation for conventional colonic cancer resection.
© 2009 S. Karger AG, Basel
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