Although the overall morbidity did increase with age, it was still less when compared to that of historical groups with traditional care. Therefore, multimodal perioperative rehabilitation should be recommended for the elderly.
"Fast-track" rehabilitation for elective colonic resection was safe and feasible in German hospitals of all sizes and yielded a low general morbidity and re-admission rate. Post-operative recovery was enhanced, but discharge from hospital was delayed because of economical reasons.
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.
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