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Fast-track open colectomy is possible in a New Zealand public hospital
Kamran Zargar-Shoshtari1, Andrew G Hill
1South Auckland Clinical School of Medicine, Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland, New Zealand.
Background:
In recent years, with the introduction of Enhanced Recovery After Surgery (ERAS) or Fast-Track protocols, perioperative care for colonic surgery has changed significantly. This is the experience of a single surgeon within a public hospital in New Zealand.
Method:
Between October 2005 and July 2007, consecutive patients undergoing segmental colonic resection by the senior author (AGH) were managed within a multimodal structured perioperative care pathway.
Results:
Thirty-two consecutive patients had elective colonic surgery without a stoma. Two were excluded because of cognitive impairment. The 30 remaining patients had a median age of 68.5 years (range 37-92) and a median daystay of 3 days (range 3-21). There were four (13%) readmissions, including one anastomotic leak.
Conclusion:
With a systematic, multidisciplinary approach, it is possible to implement and maintain a fast-track programme in a New Zealand public hospital.
