Colorectal 06

Abstract

Fast track postoperative protocols can yield a 4.3-day (d) stay after intestinal surgery, compared to 7–10 d with traditional (TRAD) approaches. Patient satisfaction, quality of life and pain are poorly understood after abdominal surgery, and have not been compared after fast track and traditional care. Sixty-four intestinal resection cases were randomly allocated to CREAD (controlled rehabilitation with early ambulation and diet) or TRAD. CREAD cases received: no NG tubes; ambulation and liquids on d 1; soft diet, oral analgesia on d 2. TRAD patients had: NG tubes; liquids, oral analgesia and diet after bowel function; ambulated on d 2. Postoperative endpoints at discharge, d 10 and d 30 used the Short Form-36 quality of life form, Cleveland clinic global quality of life scale (CGQL) and the McGill pain score. Length of stay including readmissions was 5.4 d in CREAD and 7.1 d in TRAD patients (P = 0.02). Changes in the mental component of the SF36 (reduced from 51 to 42, P < 0.01), and McGill score (increased from 3.9 to 7.6, P < 0.05) in CREAD patients at discharge, were resolved at d 10 and d 30, and are attributed to the shorter stay of CREAD patients. There were no differences in any other variable at any time. Patients using the CREAD had a shorter postoperative stay, without altered quality of life or pain scores on d 10 and d 30 after surgery, when compared to patients managed by the TRAD approach. It should be considered as a primary care pathway for patients undergoing intestinal resection.