Prospective, randomized, controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection.

摘要: INTRODUCTION: In an era of dwindling hospital resources and increasing medical costs, safe reduction in postoperative stay has become a major focus to optimize utilization healthcare resources. Although several protocols have been reported reduce stay, no Level I evidence exists for their use routine clinical practice. METHODS: Sixty-four patients undergoing laparotomy intestinal or rectal resection were randomly assigned pathway controlled rehabilitation with early ambulation diet traditional care. Time discharge from hospital, complication readmission rates, pain level, quality life, patient satisfaction scores determined at the time 10 30 days after surgery. Subgroups defined evaluate those who derived optimal benefit protocol. RESULTS: Pathway spent less total surgery (5.4 vs. 7.1 days; P = 0.02) during primary admission than patients. Patients younger 70 years old had greater benefits overall study group (5 0.01). treated by surgeons most experience significantly did whose experienced (P There was difference between score, life surgery, stay. CONCLUSIONS: scheduled are suitable management diet. shorter adverse effect on satisfaction, scores, rates. age derive benefit, increased surgeon improves outcome.