Short Hospital Stay and Low Complication Rate Are Possible with a Fully Implemented Fast-Track Model after Elective Colonic Surgery

Abstract

Purpose: The aim was to implement a fast-track model in a colorectal unit. We evaluated its effects on hospital stay and complication rate after elective open colonic surgery. Methods: A fast-track programme was fully implemented, with a dedicated staff and a schedule for all perioperative procedures which included provision of information to patients, surgical guidelines, mobilisation and postoperative care. All previously existing procedures were modified according to previously published guidelines. Criteria for success with regard to the length of hospital stay and rates and types of complications were defined. Fast-tracked patients were compared with patients not included in the programmes that were operated during the same period. Results: 131 fast-tracked patients were compared with 39 control patients. The fast track significantly reduced the median hospital stay from 7 to 3 days (p < 0.0001). There was no difference in complication rates between the two groups, and no major complications were observed after early discharge from the hospital. The readmission rate was 15% in the fast-track group and 16% with the control patients. Conclusion: Implementation of a fast track after open elective colonic surgery is safe and reduces the length of hospital stay.