Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme
- 1 February 1999
- journal article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 86 (2), 227-230
- https://doi.org/10.1046/j.1365-2168.1999.01023.x
Abstract
Background Hospital stay after colonic surgery is usually between 5 and 10 days, limiting factors being pain, ileus, organ dysfunction and fatigue. Single-modality intervention to reduce these factors with laparoscopic surgery usually requires a hospital stay of 5 days. This paper reports the results of a multimodal rehabilitation regimen after open sigmoidectomy. Methods Sixteen unselected patients scheduled for elective sigmoid resection (median age 71 years) underwent operation under combined spinal–epidural anaesthesia. After operation, epidural analgesia was continued for 48 h, with immediate oral nutrition and mobilization, and with planned discharge 2 days after surgery. Results The median postoperative hospital stay was 2 (range 2–6) days (48 h), patients being mobilized for a median of 5 h on the second postoperative day (24–48 h) and for 10 h on the third day (48–72 h). Within 48 h of operation 14 patients had an oral intake of 2000 ml or more and 15 had resumed defaecation. Fatigue and pain scores were low during the first 8–9 days after operation, with a median of 13 h of mobilization per day after discharge. There were no medical or surgical complications during 30 days of follow-up, except for two patients who suffered postspinal headache. Conclusion Postoperative recovery after open colonic surgery may be accelerated by effective pain relief integrated into an accelerated rehabilitation programme.Keywords
This publication has 7 references indexed in Scilit:
- Perioperative management of colon cancer under Medicare risk programs.Archives of Internal Medicine, 1997
- “Ideal” length of stay after colectomyDiseases of the Colon & Rectum, 1997
- Multimodal approach to control postoperative pathophysiology and rehabilitationBritish Journal of Anaesthesia, 1997
- Short-term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancerSurgical Endoscopy, 1995
- Postoperative morbidity and mortality following resection of the colon and rectum for cancerDiseases of the Colon & Rectum, 1995
- Recovery after laparoscopic colonic surgery with epidural analgesia, and early oral nutrition and mobilisationThe Lancet, 1995
- Choice of incision and pain following gallbladder surgeryBritish Journal of Surgery, 1990