'Fast-track' colonic surgery in Austria and Germany--results from the survey on patterns in current perioperative practice

Colorectal Dis. 2009 Feb;11(2):162-7. doi: 10.1111/j.1463-1318.2008.01559.x. Epub 2008 May 3.

Abstract

Objective: 'Fast-track' rehabilitation has been shown to accelerate recovery, reduce general morbidity and decrease hospital stay after elective colonic surgery. Despite this evidence, there is no information on the acceptance and utilization of these concepts among the entirety of Austrian and German surgeons.

Method: In 2006, a questionnaire concerning perioperative routines in elective, open colonic resection was sent to the chief surgeons of 1270 German and 120 Austrian surgical centres.

Results: The response rate was 63% in Austria (76 centres) and 30% in Germany (385 centres). Mechanical bowel preparation is used by the majority (Austria, 91%; Germany, 94%); the vertical incision is the standard method of approach to the abdomen in Austria (79%) and Germany (83%), nasogastric decompression tubes are rarely used, one-third of the questioned surgeons in both countries use intra-abdominal drains. Half of the surgical centres allow the intake of clear fluids on the day of surgery and one-fifth offer solid food on that day. Epidural analgesia is used in three-fourths of the institutions.

Conclusion: Although there is an evident benefit of fast-track management, the survey shows that they are not yet widely used as a routine in Austria and Germany.

MeSH terms

  • Anesthesia, Epidural / statistics & numerical data
  • Austria
  • Colectomy / rehabilitation*
  • Colorectal Surgery
  • Germany
  • Health Care Surveys
  • Humans
  • Length of Stay
  • Perioperative Care / methods*
  • Practice Patterns, Physicians'*