A Flexible Concept of Fast Track Surgery for Laparoscopic Colorectal Resections

Aim: Laparoscopy per se improves the patient outcome allowing low pain, reduction of pulmonary dysfunction or less fatigue, better mood and psychological status on the operated on patient. In this study a series of laparoscopic colorectal resections underwent fast track in a "flexible" way.

Methods: From March 2006 to March 2009, 75 patients undergoing laparoscopic colectomy for cancer have been prospectively evaluated. There were 46 males and 29 females with 61.4 years mean age (26-87). The cohort was divided in three group, 25 patient each, on the basis of the fast track treatment used. In the series A fast track on the whole, in the B fast track partial and in the C fast track postoperatively only.

Results: Mean operating time was 81, 118, 142/76, 110, 151/83, 126, 145 minutes for right colectomy, left colectomy and rectal resection respectively in group A, B and C. The postoperative pain rating was less in the group A compared to B and C, with no differences concerning mobilization, flatus, resumption of solid feeding and mean postoperative hospital stay.

Conclusion: Fast track management in laparoscopic colectomy is safe and effective, but it seems not essential in reducing the total hospital stay.