[Two days' hospital stay after laparoscopic colon resection]

In order to reduce surgical stress-induced dysfunction and morbidity in the postoperative period after colon cancer surgery in old people, we performed the operations laparoscopically and optimized the postoperative regime especially as regards to treatment of pain, early oral intake and mobilisation. The patients were treated with continuous epidural infusion of local anaesthetic for 48 hours postoperatively. Morphine was avoided. Normal oral intake was allowed immediately after operation and active mobilisation was ensured. Twenty patients with a median age of 81 years (71-92 years), who preoperatively were able to take care of themselves at home, entered the study. In four the operation was converted to open surgery due mainly to growth of the cancer into neighbouring organs. One patient had to have an open reoperation due to small bowel strangulation. Fifteen followed the scheduled programme. They all had normal bowel function on day one or two and were mobilised for eight hours on day two and 12 hours on day three. Accordingly postoperative hospital stay was only two days (median), and the high level of activity continued at home after discharge. The combination of laparoscopic mini-invasive surgical technique and a postoperative regime that optimized pain treatment, early oral intake and active mobilisation considerably reduced postoperative convalescence after colon cancer surgery in old patients.