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2011 | 83 | 9 | 482-487

Article title

Implementation of the Fast Track Surgery in Patients Undergoing the Colonic Resection - Own Experience


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A perioperative care in the colorectal surgery has been considerably changed recently. The fast track surgery decreases complications rate, shortens length of stay, improves quality of life and leads to cost reduction. It is achieved by: resignation of a mechanical bowel preparation before and a nasogastric tube insertion after operation, optimal pain and intravenous fluid management, an early rehabilitation, enteral nutrition and removal of a vesical catheter and abdominal drain if used.The aim of the study was to compare the results of an implementation the fast track surgery protocol with results achieving in the conventional care regimen.Material and methods. Two groups of patients undergoing colonic resection have been compared. The study group was formed by patients treated with fast track concept, the control group - by patients who were dealt with hitherto regimen. Procedures needed stoma performing, rectal and laparoscopic surgery were excluded. The perioperative period was investigated by telephone call to patient or his family.Results. Statistical significant reduction was reached in a favour of the fast track group in the following parameters: the length of hospital stay (2.5 days shorter), duration of an abdominal cavity and vesicle drainage (3 and 2 days shorter respectively), postoperative day on which oral diet was implemented (2,5 days faster) and finally extended (1.5 days faster). There were no statistical difference in mortality, morbidity neither reoperation rate between two groups.Conclusion. The fast track surgery is a safe strategy and may improve a perioperative care.









Physical description


1 - 9 - 2011
5 - 10 - 2011


  • Department of General, Gastroenterological and Oncological Surgery of the Central Public Clinical, Hospital Warsaw Medical University
  • Department of General, Gastroenterological and Oncological Surgery of the Central Public Clinical, Hospital Warsaw Medical University


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  • Kehlet H, Wilmore DW: Evidence-Based Surgical Care and the Evolution of Fast - track surgery. Ann Surg 2008; 248: 189-98.
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  • Brady MC, Kinn S, Stuart P, Ness V: Preoperative fasting for adults to prevent perioperative complications. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD004423.[WoS]
  • Slim K, Vicaut E, Launay-Savary MV et al.: Updated systematic review and metaanalysis of randomized clinical trials on the role of mechanical bowel preperation before colorectal surgery. Ann Surg 2009; 249: 203-309.[WoS]
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  • Wu CL, Cohen SR, Richman JM: Efficacy of Postoperative Patient-controlled and Continuous Infusion Epidural Analgesia versus Intravenous Patient-controlled Analgesia with Opioids. Anesthesiology 2005; 103:1079-88.
  • Liu SS, Richman J, Thirlby RC et al.: Efficacy of Continuous Wound Catheters Delivering Local Anesthetic for Postoperative Analgesia: A Quantitative and Qualitative Systematic Review of Randomized Controlled Trials. J Am Coll Surg 2006; 203: 914-32.
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  • Wang G, Jiang ZW, Xu J et al.: Fast-track rehabilitation program vs conventional care after colorectal resection: A randomized clinical trial. World J Gastroenterol 2011; 17(5): 671-76.[WoS][Crossref]

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