Which fast track elementspredict early recovery after colon cancer surgery?: P149


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Abstract

Aim:To determine which elements within a fast trackprogramme were independentpredictors of faster postoperative recovery in patients that underwent a resection for colon cancer.Method:Data from the LAFA-trial database was used. In this trial, fast track care was compared with standard perioperative care in 400 patients undergoing laparoscopic or open colon surgery. During admission the fast track elements wereprospectively evaluated per patient and scored if successfully applied. To identifypredictive factors all fast track items and seven baseline characteristics were entered in a univariable and multivariable Cox regression analysis with total postoperative hospital stay (i.e. faster recovery) asprimary outcome factor.Results:In 400 patients, two baseline characteristics and two fast track elements were found to be significant independentpredictors on total postoperative hospital stay; female sex [hazard ratio (HR) 1.26; P = 0.030], laparoscopic resection [HR 1.34; P = 0.005], ‘normal diet at postoperative days 1, 2 & 3 [HR 1.87; P < 0.001] and ’enforced mobilisation at postoperative days 1,2 & 3 [HR 1.72; P < 0.001].Conclusion:The key to success of fast trackprogrammes cannot be ascribed to a single (set of) item(s), but seems more likely related to theprotocolised management of postoperative care.

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