Background: Fast-track protocols are followed by an enhanced recovery, early return to bowel function and to complete nutrition, and a reduced hospital stay. Our study was designed to implement fast-track protocol in our university hospital.
Methods: The 96 consecutive patients with colorectal neoplasm included in the study were randomized in two equal groups: group 1 (FT) included patients undergoing colorectal surgery in a fast-track protocol, and group 2 (C) included patients undergoing colorectal surgery with a conventional care protocol. As with other fast-track protocols, our protocol included carbohydrate fluids load before operation, early mobilization and oral feeding, regular prokinetics, and multimodal postoperative analgesia. Time to restoration of bowel function, to complete mobilization and feeding, length of hospital stay, and incidence of complications and readmissions were monitored.
Results: Time to mobilization, restoring of bowel function, and complete oral feeding were significantly shorter with fast-track protocol (p = 0.001, p = 0.042, and p = 0.01, respectively). Hospital stay also was shorter in the fast-track group (p = 0.001). The incidence of complications did not significantly differ with the study groups.
Conclusions: In our study, fast-track protocol resulted in a shorter time to mobilization, complete feeding, and discharge from hospital. Fast-track protocol did not increase the incidence of complications. However, we consider that our data require further confirmation with powered multicenter national studies.
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http://dx.doi.org/10.1007/s00268-009-0197-x | DOI Listing |
J Cardiothorac Vasc Anesth
December 2024
Department of Medical Science, Surgery and Neurosciences, Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy. Electronic address:
Objective: This study investigated if the serratus anterior plane block (SAPB) within a multimodal analgesia scheme would reduce acute post-operative pain and intravenous opioid consumption in patients admitted to the intensive care unit after isolated minimally invasive mitral valve surgery.
Design: Retrospective study.
Setting: Patients were admitted to the intensive care unit (ICU) of the University Hospital of Siena (Italy).
Res Pract Thromb Haemost
January 2025
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Background: Venous thromboembolism (VTE) is a serious complication following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Despite improvements with fast-track treatment protocols, 0.5% of patients still develop a VTE within 90-days postoperatively.
View Article and Find Full Text PDFInt Emerg Nurs
January 2025
CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of Berkeley, Berkeley, CA, USA. Electronic address:
Background: Crowding and patient flow management are among the most relevant issues for emergency departments (EDs). This results in delayed treatment, adverse outcomes and increased costs. For these reasons, nurse-independent treatment protocols were developed aimed at managing non-emergency patients outside EDs thus improving patient flow.
View Article and Find Full Text PDFJTCVS Open
December 2024
Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Background: Minimally invasive mitral valve repair (MIMVR), often performed within specialized care pathways, has been shown to reduce hospital length of stay and improve patient recovery. The relative value of rapid-recovery protocols as a component of care pathways, including enhanced recovery programs (ERPs), has not been well described. This study compared clinical outcomes following implementation of a new, comprehensive rapid-recovery protocol within a previously established, mature ERP for patients undergoing MIMVR.
View Article and Find Full Text PDFBMC Musculoskelet Disord
December 2024
Department of Surgery, Hospital Nova of Central Finland, Wellbeing Services County of Central Finland, Jyväskylä, University of Eastern Finland, Kuopio, Finland.
Background: The optimal length of thromboprophylaxis after total hip or knee arthroplasty (THA and TKA) is unknown. Fast-track protocols have improved patient care and led to shorter immobilization and length of stay (LOS) after THA and TKA, thereby diminishing venous thromboembolism (VTE) risk. Here, we investigated risk stratification-based thromboprophylaxis after fast-track THA and TKA.
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