Colostomy Closure After Hartmann's Procedure With Fast-Track Rehabilitation

Abstract
The aim of this study was to assess the effect of postoperative multimodal rehabilitation after colostomy closure after Hartmann's procedure. Twenty-seven consecutive patients scheduled for colostomy closure after Hartmann's procedure received continuous postoperative epidural analgesia, laxative, and enforced oral liquids, protein drinks, and mobilization. Defecation occurred at a median 2 days postoperatively. Mean and median postoperative stay was 3 days, with two readmissions (1 anastomotic dehiscence and 1 social) increasing mean total 1-month hospital stay to 4.3 (median, 3) days. No other complications occurred except three superficial wound infections. Postoperative hospital stay and morbidity may be reduced with multimodal rehabilitation after open colostomy closure after Hartmann's resection.