Abstract

Background:  The aim of the study was to evaluate the efficacy and safety of fast track rehabilitation in elderly patients over 65 years following laparoscopic surgery to remove colorectal cancer. Method:  A total of 78 elderly patients with colorectal cancer who underwent laparoscopic colorectal resection were randomly assigned to receive either the fast track care program (FT group, N = 40) or the conventional perioperative care protocol (control group, N = 38). Medical personnel conducting the study were blinded to patients' clinical outcomes prior to statistical analysis. The fast track protocol included no preoperative mechanical bowel irrigation, immediate oral alimentation and earlier ambulation exercise post-operation. The length of postoperative hospital stay, the length of time for the regain of bowel function and the rate of postoperative complications were compared between two groups. Results:  The length of time for regained bowel function, including passage of flatus, (31 [26-40] h vs. 38[32-51] h, p = 0.001); bowel movement (55 [48-63] h vs. 64[48-71] h, p =0.009); and the time to liquid diet (12 [11-16] h vs. 47[35-50] h, p = 0.000) were significantly shorter in patients with the fast track care protocol compared to those in patients with the conventional care. Shorter duration of postoperative hospital stay was recorded in patients with fast track program than that in the control group (p=0.0001). A reduced percentage of patients who developed general complications was also observed in FT group (5.0% vs 21.1%., p= 0.045). Conclusions:  This randomized controlled trial has shown that in the elderly undergoing laparoscopic colorectal surgery, the fast track recovery program demonstrated a more rapid postoperative recovery, earlier discharge from hospital and fewer general complications compared to a conventional postoperative protocol.

Copyright © 2011 The Association of Coloproctology of Great Britain and Ireland.

[Follow this link to read online]