ABSTRACT
BACKGROUND: "Fast Track surgery" is a therapeutic program of large application, despite some doubts about its applicability and real validity. Literature review shows that this approach to colo-rectal surgery, particularly video-assisted, can allow a rapid recovery, better performance and a faster postoperative functional autonomy of the work, which can be discharged without cause additional welfare costs; in addition it can be reproducible in different health reality. PURPOSE: To analyze the possibility to apply the Fast Truck protocol in patients undergoing colorectal surgery in a rural hospital and non specialistic Unit of Surgery. PATIENTS AND METHODS: We have conducted a prospective, randomized study on 80 patients subjected to colorectal surgery in the last year. RESULTS: The protocol was observed in 95% of cases, compliance with the Fast Track was high and general morbidity was limited (7.8%). CONCLUSION: This "aggressive" approach, which has fundamentally altered the usual surgical behavior, seems to allow a mean length of stay significantly lower than in controls (p < 0.05) with positive implications for patients and containment of health care costs, even after discharge (no need for home care in 92% of cases, no early re-admittance to the hospital). Homogeneous protocols are desirable, as well as an increased enrollment, to consolidate these rehabilitation programs in order to provide a reference for all hospitals.
Subject(s)
Colonic Diseases/surgery , Rectal Diseases/surgery , Adult , Aged , Aged, 80 and over , Digestive System Surgical Procedures/methods , Female , Hospitals, Rural , Humans , Male , Middle Aged , Prospective Studies , Time FactorsABSTRACT
Although colonic diverticulum is a common disease, affecting about 35% of patients above the age of 60, giant sigmoid diverticulum is an uncommon variant of which only relatively few cases have been described in the literature. We report on our experience with a patient affected by giant sigmoid diverticulum who was treated with diverticulectomy. Resection of the diverticulum is a safe surgical procedure, provided that the colon section close to the lesion presents no sign of flogosis or diverticula; in addition, recurrences are not reported after 6-year follow-up.