Open Right-sided Colonic Fast-track Surgery is Associated with Shorter Hospital Stay but more Re-admissionsIlja Lejbman*, Olle Rosengren, Johan Bernland, Dorothea Joost, Åke Mellström and Jonas Åkeson
Department of Anesthesiology and Intensive Care Medicine, Skåne University Hospital, Lund University, Inga Marie Nilssons gate 47, 3rd floor, Malmö, Sweden
- *Corresponding Author:
- Ilja Lejbman
Department of Anesthesiology and Intensive Care Medicine
Skåne University Hospital, Inga Marie Nilssons gate 47
3rd floor, Malmö, Sweden
E-mail: [email protected]
Received date: February 03, 2017; Accepted date: March 25, 2017; Published date: April 03, 2017
Citation: Lejbman I, Rosengren O, Bernland J, Joost D, Mellström A, et al. (2017) Open Right-sided Colonic Fast-track Surgery is Associated with Shorter Hospital Stay but more Re-admissions . J Surg Anesth 1:102.
Copyright: © 2017 Lebjman I, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Fast-track (FT) surgery programs – based on recognized clinical guidelines including opioid and fluid restriction, epidural analgesia, and early mobilization – have been introduced to optimize patient recovery after various surgical procedures. This study was designed to evaluate – with respect to hospital stay, complications, and re-admission rate – a local FT program for patients undergoing open right-sided hemi colectomy at a large urban university hospital in southern Sweden.
Methods: We compared retrospectively 86 study patients subjected to open right-sided hemi colectomy after implementation of the FT program (January 2006 – December 2007) with 86 control patients, matched for gender and age, before implementation (January 2000 – February 2005). Patient records were used as the primary source of data. Total hospital stay was the primary endpoint. Secondary endpoints were re-admission, reoperation, complication, and mortality rates.
Results: Median total hospital stay was shorter in study compared with control patients (7 vs. 9 days; P<0.001), but more study than control patients were re-admitted within 30 days (9.3% vs. 2.3%; P=0.046). The patient groups did not differ in reoperation, complication, or mortality rates.
Conclusion: This study has shown that clinical implementation of an FT program was associated with shorter hospital stay after open right-sided hemi colectomy, however at the price of more patient re-admissions. Fast-track programs should be evaluated with particular emphasis on hospital re-admissions, and specific measures be taken to identify high-risk patients not to discharge them too early.