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DOI: 10.1055/s-2008-1076974
© Georg Thieme Verlag Stuttgart ˙ New York
„Fast-track”-Rehabilitation zur Beschleunigung der Rekonvaleszenz nach Ileostomarückverlagerung – eine prospektive kontrollierte Studie
„Fast-Track” Rehabilitation to Enhance Recovery after Ileostomy Closure – A Prospective Clinical TrialPublication History
Publication Date:
15 October 2008 (online)
![](https://www.thieme-connect.de/media/zblchir/200805/lookinside/thumbnails/10.1055-s-2008-1076974-1.jpg)
Zusammenfassung
Hintergrund: Bei kolorektalen Operationen konnte die Verweildauer durch die Implementierung von multimodalen, sogenannten „Fast-track”-Schemata zur Beschleunigung der Rekonvaleszenz verkürzt werden. Die vorliegende prospektive kontrollierte Studie sollte zeigen, ob die „Fast-track”-Behandlung auch bei elektiven Ileostomarückverlagerungen zu einer Verkürzung des Krankenhausaufenthaltes führt. Patienten und Methoden: Alle Patienten, die sich einer elektiven Rückverlagerung eines protektiven doppelläufigen Ileostomas unterzogen, wurden prospektiv untersucht. Dabei wurde eine Gruppe (n = 20) nach einem konventionellen Therapieschema behandelt. Bei der zweiten Gruppe (n = 20) erfolgte der konsequente Einsatz eines „Fast-track”-Therapieschemas mit Verzicht auf Opioidanalgesie, frühzeitiger enteraler Ernährung und Mobilisation. Ergebnisse: Der orale Kostaufbau mit flüssiger und fester Ernährung gelang in der „Fast-track”-Gruppe früher als in der Kontrollgruppe. Dabei kam es nicht zu einem Anstieg der postoperativen Komplikationen. Die Patienten der „Fast-track”-Gruppe konnten im Median 3 Tage früher aus der stationären Behandlung entlassen werden (p = 0,01). Schlussfolgerung: Die konsequente Implementierung eines „Fast-track”-Therapieschemas kann zu einer Reduktion der Krankenhausverweildauer nach elektiver Ileostomarückverlagerung beitragen.
Abstract
Background and Aims: After colorectal resections, concepts for early recovery (ERAS or fast-track) could reduce the length of the hospital stay. Whether or not such a multimodal treatment can shorten the hospitalisation after loop ileostomy closure was investigated in the present study. Patients and Methods: All patients admitted for elective closure of a loop ileostomy were prospectively investigated. The first group (n = 20) was postoperatively treated in a conventional manner. In the other group (n = 20), a concept for “fast-track” rehabilitation including early oral feeding, early mobilisation and abandonment of opioid analgesia was used. Results: Oral feeding with liquids and solid food was tolerated in the “fast-track” group earlier than after conventional treatment. There was no increase in the incidence of postoperative complications. Patients of the “fast-track” group could be discharged 3 days earlier on average (p = 0,01). Conclusion: “Fast-track” rehabilitation can shorten the length of hospitalisation after elective ileostomy closure.
Schlüsselwörter
Ileostoma - perioperative Behandlung - Rekonvaleszenz - Morbidität
Key words
ileostomy closure - fast-track - rehabilitation - morbidity
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Dr. med. W. Raue
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