Year 2012 Vol. 20 No 5

LECTURES, REVIEWS

J.A. SIAMIONOVA

PRINCIPLES OF MULTICOMPONENT FAST-TRACK PROGRAM IN COLORECTAL SURGERY: APPROACHES AND POSITIVE EFFECTS

SEE “Belarusian Academy of Post-Graduate Education”
The Republic of Belarus

Analytical review of the scientific literature concerning the perioperative care of patients undergoing colonic resection with primary anastomosis application is presented in the article. Traditional perioperative care is associated with high postoperative complication rate and prolonged hospital stay. The approach introduction of an alternative, based on the principles of fast-track surgery when conducting the perioperative period has been expanded recently. The history of elaboration, basic elements and positive effects of fast-track surgery are described.
Advantages of the given approach permitting earlier terms of recovery, reduction of postoperative complications, length of hospital stay and treatment costs are highlighted. Basic tendencies of the program are absence of the mechanical bowel preparation and restriction of the prolonged preoperative starving before surgery, epidural anesthesia, intraoperative fluid management, avoidance of intra-abdominal drains, early enteral nutrition and active mobilization in the postoperative period.
However, the role of some elements of the program, such as prolonged epidural anesthesia, terms and quality of early enteral nutrition, abdominal cavity drainage are still debatable and evidence-based indications and terms of use require further study.

Keywords: colonic resection, postoperative care, fast track surgery, postoperative complications
p. 116 - 122 of the original issue
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Address for correspondence:
220013, Respublika Belarus, G. Minsk, ul. P.Brovki, d. 3, korp. 3, GUO «Belorusskaya meditsinskaya akademiya poslediplomnogo obrazovaniya», kafedra hirurgii,
e-mail: dzuliya2009@yandex.ru,
Semyonova Yuliya Aleksandrovna
Information about the authors:
Siamionova J.A. Post-Graduate Student of the Surgery Chair of SEE “Belarusian Academy of Post-Graduate Education”.
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