Zargar-Shoshtari K et al. (2008) Fast-track surgery may reduce complications following major colonic surgery. Dis Colon Rectum 51: 1633–1640

Enhanced recovery after surgery (ERAS), or fast-track, perioperative care programs have been developed over the past 10 years to accelerate recovery after major surgeries; however, concerns have been raised about protocol compliance within these programs, and their effect on rates of readmission and complications. A study conducted by Zargar-Shoshtari and colleagues has shown that a fast-track, perioperative-care approach is associated with reduced duration of hospital stay and a reduced rate of complications compared with a standard approach.

The authors evaluated the influence of an ERAS program for consecutive patients who underwent elective colonic resection at their hospital in Auckland between December 2005 and March 2007. ERAS patients (n = 50) were compared with a comorbidity-matched, historical group of patients (n = 50) who had undergone similar surgery before initiation of the ERAS program. In comparison with the control group, ERAS patients received significantly smaller amounts of intraoperative and postoperative intravenous fluids; they also consumed their first meal after surgery, were mobilized, passed flatus, and were discharged significantly earlier (4 days vs 6.5 days). In addition, significantly fewer patients on the ERAS program had urinary infections, ileus and cardiopulmonary complications. Readmission rates were similar in the two groups. ERAS protocol compliance was 80% during the time from admission to surgery, and 40% for the duration of the postoperative stay.

The authors conclude that ERAS or fast-track, perioperative care programs “...are safe and should be considered for introduction into routine clinical practice.”