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Chirurgie 6. Mai 2015

Compliance with and fulfillment of a fast-track protocol in daily surgical practice in a university hospital

Background: The aim of this retrospective study was to analyze the fulfillment of different fast-track elements in daily surgical practice.

Methods: One hundred and forty-nine consecutive patients (69 female, 46 %) with a median (range) age of 68(33–93), were analyzed.

Results: In 46 % of patients no oral bowel preparation was performed. Successful placement of patent ductus arteriosus (PDA) was reached in 94(63 %) patients. Nasogastric tube was removed in 97 %, a drain was placed in 94(63 %) patients. The urine catheter was removed in 43 % until postoperative day (POD) 3. No intravenous medication was recorded in 25(16 %) patients on POD1. In 47(32 %) patients deviation from the postoperative fast-track protocol was observed. Hospital mortality was 0.7 % and rehospitalization rate was 5 %(n = 7).

Conclusion: In summary, this study shows that the extension of the enhanced recovery of surgery (ERAS) protocol in a large department with a great number of staff involved is challenging and needs permanent supervision. Bowel preparation and epidural anesthesia were the elements with worse compliance.

 

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