Fast-track colonic surgery can be successfully implemented in community hospitals. Two recent studies provide further evidence of the benefits of this fast-track surgical approach on postoperative gastrointestinal recovery after laparoscopic and open procedures. The issue is no longer whether fast-track colonic surgery is better than standard care, but how to improve the approach and its implementation.
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References
Archibald, L. H. et al. Enhanced recovery after colon surgery in a community hospital system. Dis. Colon Rectum 54, 840–845 (2011).
van Bree, S. et al. Faster recovery of gastrointestinal transit after laparoscopy and fast-track care in patients undergoing colonic surgery. Gastroenterology http://dx.doi.org/10.1053/j.gastro.2011.05.034.
Vlug, M. S. et al. Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study). Ann. Surg. http://dx.doi.org/10.1097/SLA.0b013e31821fd1ce.
Kehlet, H. & Wilmore, D. W. Evidence-based surgical care and the evolution of fast-track surgery. Ann. Surg. 248, 189–198 (2008).
Spanjersberg, W. R., Reurings, J., Keus, F. & van Laarhoven, C. J. H. M. Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst. Rev. Issue 2. Art. No.: CD007635. http://dx.doi.org/10.1002/14651858.CD007635.pub2 (2011).
Varadhan, K. K. et al. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin. Nutr. 29, 434–440 (2010).
Kehlet, H. Fast-track surgery—an update on physiological care principles to enhance recovery. Langenbecks Arch. Surg. 396, 585–590 (2011).
Basse, L. et al. Functional recovery after open versus laparoscopic colonic resection: a randomized, blinded study. Ann. Surg. 241, 416–423 (2005).
Gustafsson, U. O. et al. Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery. Arch. Surg. 146, 571–577 (2011).
Kehlet, H. & Mythen, M. Why is the surgical high-risk patient still at risk? Br. J. Anaesth. 106, 289–291 (2011).
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Kehlet, H. Fast-track colonic surgery and the 'knowing–doing' gap. Nat Rev Gastroenterol Hepatol 8, 539–540 (2011). https://doi.org/10.1038/nrgastro.2011.153
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DOI: https://doi.org/10.1038/nrgastro.2011.153
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