Asian Oncol Nurs.  2014 Dec;14(4):249-253. 10.5388/aon.2014.14.4.249.

Outcomes of Fast-Track Program after Colorectal Cancer Surgery - Comparison with Conventional Method

Affiliations
  • 1Department of Nursing, Seoul National University Hospital, Seoul, Korea. goddess11@naver.com
  • 2Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
  • 3Department of Nursing, Kyungmin College, Uijeongbu, Korea.

Abstract

PURPOSE
To assess the effectiveness of a care map for a fast-track discharge program after colorectal cancer surgery.
METHODS
Ninety-nine patients who underwent colorectal surgery were retrospectively analyzed: 45 patients who were placed in a conventional program (January 3 to March 13, 2013) and 44 patients who were placed in a fast-track program using the care map (July 26 to September 24, 2014). Patients in the fast-track program started eating on postoperative day 1, while those in the conventional program started eating on post-operative day 2. complications, and pain were compared between the two groups.
RESULTS
A slight decrease in the average duration of hospitalization was observed for the fast-track group (5.31+/-0.98 days) compared to the conventional group (5.38+/-2.80 days), although this difference was not statistically significant. All other outcomes for the fast-track group were scored as 0. Furthermore, there was no statistically significant differences between pain, narcotics administration, and non-narcotic analgesics (aside from patient-controlled analgesia).
CONCLUSION
The care map for the colorectal surgery fast-track program was effective and program validation and supplementation of the active standardization early recovery program should be performed using multi-disciplinary research.

Keyword

Colorectal Surgery; Fast-Track

MeSH Terms

Analgesics, Non-Narcotic
Colorectal Neoplasms*
Colorectal Surgery
Eating
Hospitalization
Humans
Narcotics
Retrospective Studies
Analgesics, Non-Narcotic
Narcotics

Reference

1. Lee IK. Fast-track colorectal surgery. J Korean Soc Coloproctol. 2010; 26:87–92.
Article
2. Kumar A, Scholefield JH, Andersen J, Armitage NC. Fast track surgery. In : Johnson C, Taylor I, editors. Recent Advances in Surgery. 2006. 29:p. 59–74.
3. Cheah J. Development and implementation of a clinical pathway programme in an acute care general hospital in Singapore. Int J Qual Health Care. 2000; 12:403–412.
Article
4. Lee EO, Im NY, Park HY, Lee IS, Kim JI, Bae JE, et al. Nursing research and statistical analysis. Seoul: Soomoon-sa;2009.
5. Woodhouse A, Hobbes AFT, Mather LE, Gibson M. A comparison of morphine, pethidine and fentanyl in the postsurgical patient-controlled analgesia (PCA) environment. Pain. 1996; 64:115–121.
Article
6. Zhu L, Li J, Li XK, Feng JQ, Gao J. Impact of a clinical pathway on hospital costs, length of stay and early outcomes after hepatectomy for hepatocellular carcinoma. Asian Pac J Cancer Prev. 2014; 15:5389–5393.
Article
7. Kim EO. Effects of a standardized critical pathway in gastrectomy patients [dissertation]. Seoul: Seoul National Univ.;2004.
8. Wang Q, Suo J, Jiang J, Wang C, Zhao YQ, Cao X. Effectiveness of fast-track rehabilitation vs conventional care in laparoscopic colorectal resection for elderly patients: a randomized trial. Colorectal Dis. 2012; 14:1009–1013.
Article
9. Muller S, Zalunardo MP, Hubner M, Clavien PA, Demartines N. A fast-track program reduces complications and length of hospital stay after open colonic surgery. Gastroenterology. 2009; 136:842–847.
Article
10. Delaney CP, Zutshi M, Senagore AJ, Remzi FH, Hammel J, Fazio VW. Prospective, randomized, controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection. Dis Colon Rectum. 2003; 46:851–859.
Article
11. Baek SJ, Kim SH, Kim SY, Shin JW, Kwak JM, Kim J. The safety of a "fast-track" program after laparoscopic colorectal surgery is comparable in older patients as in younger patients. Surg Endosc. 2013; 27:1225–1232.
Article
12. Mari GM, Costanzi A, Maggioni D, Origi M, Giovanni C, De Martini P, et al. Fast-track versus standard care in laparoscopic high anterior resection: a prospective randomized-controlled trial. Surg Laparosc Endosc Percutan Tech. 2014; 24(2):118–121.
13. Van Bree SH, Vlug MS, Bemelman WA, Hollmann M, Ubbink D, Zwinderman K, et al. Faster recovery of gastrointestinal transit after laparoscopy and fasttrack care in patients undergoing colonic surgery. Gastroenterology. 2011; 141:872–880.
Article
14. Beazley S, Brady AM. Integrated care pathways in orthopaedics: a literature review. J Orthop Nurs. 2006; 10:171–178.
Article
15. Spanjersberg WR, Reurings J, Keus F, van Laarhoven CJ. Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst Rev. 2011; 16(2):CD007635.
Article
16. Gouvas N, Tan E, Windsor A, Xynos E, Tekkis PP. Fast-track vs standard care in colorectal surgery: a meta-analysis update. Int J Colorectal Dis. 2009; 24:1119–1131.
Article
17. Wennstrom B, Stomberg MW, Modin M, Skullman S. Patient symptoms after colonic surgery in the era of enhanced recovery-a long-term follow-up. J Clin Nurs. 2010; 19:666–672.
18. Norlyk A, Martinsen B. The extended arm of health professionals? Relatives' experiences of patient's recovery in a fast-track programme. J Adv Nurs. 2013; 69(8):1737–1746.
Article
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