Fast track programmes vs. traditional care in laparoscopic colorectal surgery: a meta-analysis of randomized controlled trials.

ABSTRACT

BACKGROUND/AIMS: To assess the efficacy and safety of fast track (FT) programmes in laparoscopic colorectal surgery by comparing FT programmes with traditional care in randomized controlled trials (RCTs). METHODOLOGY: RCTs comparing the effects of FT programmes and traditional care in the same context of laparoscopic colorectal surgery were found on PubMed, EMBASE and Cochrane Library. Primary hospital stay, overall hospital stay, readmission rate, morbidity and mortality were assessed. RESULTS: Four original RCTs investigating a total of 486 patients, of whom 235 received FT programmes and 251 received traditional care, met the inclusion criteria. The pooled weighted mean difference in primary hospital stay and overall hospital stay was -1.22 (95% CI -1.57 to -0.87) and -1.00 (95% CI -1.48 to -0.52), which showed a significant reduction with use of FT programmes (p < 0.05). The pooled odds ratio for readmission rate, morbidity and mortality was 0.85 (95% CI 0.33 to 2.21), 0.68 (95% CI 0.44 to 1.04) and 1.51 (95% CI 0.29 to 7.77), suggesting no significant difference between the two groups (p > 0.05). CONCLUSIONS: FT programmes in elective laparoscopic colorectal surgery could significantly reduce primary hospital stay and overall hospital stay, and with no significant difference in readmission rate, morbidity and mortality compared with traditional care.