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Updated: May 3, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Fast-track management is safe and effective after bowel resection in children with Crohn's disease
Jesse D Vrecenak1, Peter Mattei1
1The Children's Hospital of Philadelphia, Philadelphia, PA.
Insights
Fast-track (FT) management is safe and effective for pediatric Crohn's disease (CD) patients undergoing ileocecectomy. This approach reduces hospital stay and speeds recovery without increasing complications.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pediatric Surgery
Background:
- Fast-track (FT) management aims to reduce postoperative discomfort and optimize inpatient care.
- Its application in pediatric Crohn's disease (CD) with underlying bowel inflammation requires careful examination.
Purpose of the Study:
- To evaluate the outcomes of laparoscopic-assisted ileocecectomy for CD using FT principles.
- To assess the impact of FT on recovery parameters and complications in pediatric CD patients.
Main Methods:
- Retrospective review of 71 pediatric patients (aged 8-18) undergoing isolated laparoscopic-assisted ileocecectomy for CD (2000-2010).
- Comparison of outcomes between 45 patients managed with FT and those not meeting FT criteria.
Main Results:
- FT management was associated with decreased length of stay (LOS), time to first stool, time to full diet, and reduced intravenous narcotic use.
- No significant differences in complications or disease progression were observed between FT and non-FT groups over 2-year follow-up.
Conclusions:
- FT management is a safe and effective strategy for pediatric CD patients undergoing ileocecectomy.
- Patient and family counseling regarding early discharge is crucial for FT success in this chronically ill population.
- FT offers benefits in LOS, bowel function recovery, and narcotic use without compromising safety.
Background:
"Fast-track" management (FT) challenges traditional postoperative tenets in order to minimize discomfort and optimize inpatient care. We examined the outcomes of consecutively performed laparoscopic-assisted ileocecectomy for Crohn's disease (CD), with particular focus on FT's effects in patients with underlying bowel inflammation.
Methods:
We retrospectively reviewed all patients undergoing isolated laparoscopic-assisted ileocecectomy for CD at our institution between 12/2000 and 12/2010, excluding patients with multiple areas of surgical CD, bladder involvement, or age >18years.
Results:
Seventy-one patients aged 8-18years underwent isolated laparoscopic-assisted ileocecectomy for CD, of which 45 met FT criteria. Individual practice patterns primarily determined which patients were FT-managed. FT management led to decreased length of stay (LOS), time to first stool, time to full diet, and intravenous narcotic use. No significant difference in complications or disease progression was observed between the two groups during 2-year follow up.
Conclusions:
Our results suggest that FT is safe and effective in patients with CD. In a chronically ill population, counseling patients and families to expect early discharge is critical to the success of this strategy. Despite CD-related GI pathology, FT patients realized benefits in terms of LOS, time to bowel function, and narcotic use without any increase in complications.
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