NDLI: Laparoskopische 'Fast-track'-Sigmaresektion bei Divertikulitis in Deutschland. Ergebnisse einer prospektiven Qualitätssicherungsmassnahme.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Tsilimparis, N. Haase, O. Wendling, P. Kipfmüller, K. Schmid, M. Engemann, R. Schwenk, W.
Spatial Coverage	Germany
Description	Author Affiliation: Tsilimparis N ( Klinik für Allgemein-, Visceral-, Gefäss- und Thoraxchirurgie, Charité- Universitätsmedizin Berlin.)
Abstract	BACKGROUND AND OBJECTIVE: The natural course of sigmoid colon diverticulitis during conservative therapy and the assessment of the perioperative morbidity after sigmoid colon resection are differently evaluated by surgeons and gastroenterologists. The 'fast-track' rehabilitation accelerates the reconvalescence and reduces the rate of postoperative general complications after colorectal surgery. The results of the laparoscopic 'Fast-track' sigmoidectomy should be examined within a quality assurance program to better evaluate the perioperative risks following surgical management of diverticulitis. PATIENTS AND METHODS: A prospective data collection within the voluntary quality assurance program 'fast-track' Kolon II was performed. All participating clinics agreed on a multimodal, evidence-based standard perioperative treatment in terms of a 'fast-track' rehabilitation for elective operations for sigmoid diverticulitis. RESULTS: Data from 846 patients undergoing laparoscopic 'fast-track' sigmoid colon resection in 23 surgical departments in Germany were collected and evaluated. The mean age of the patients was 63 years (range 23 - 91). 203 patients (24 %) had severe co-morbidities (ASA classification III - IV). A conversion to conventional open surgery was necessary in 51 cases (6 %). Complications occurred in 93 patients (11 %). 76 patients suffered a surgical complication (8.9 %) and 32 patients (3.8 %) a general complication. Two patients died postoperatively due to multi-organ failure following anastomotic leaks. The patients took solid food in median on day 1 after surgery (range, 0 - 5) and passed stool on day 2 (range, 0 - 22). Predefined discharge criteria (free of pain on oral medication, normal oral feeding, stool) were met on day 4 (range, 1 - 58) and the patients were discharged on day 7 (range, 3 - 72). The 30-day re-admission rate was 3.9 %. CONCLUSION: Patients undergoing laparoscopic 'fast-track' sigmoidectomy had a low rate of general complications and had a rapid reconvalescence with a short postoperative in-patient treatment as documented in a german quality assurance program.
File Format	HTM / HTML
ISSN	00120472
Issue Number	36
Volume Number	135
e-ISSN	14394413
Journal	DMW - Deutsche Medizinische Wochenschrift
Language	German
Publisher	Thieme Medical Publishers
Publisher Date	2010-09-01
Publisher Place	Germany
Access Restriction	Subscribed
Subject Keyword	Discipline Medicine Colon, Sigmoid Surgery Diverticulitis, Colonic Postoperative Complications Epidemiology Sigmoidoscopy Standards Adult Aged Aged, 80 And Over Evidence-based Medicine Female Germany Humans Male Middle Aged Prospective Studies Quality Control Young Adult English Abstract Journal Article
Alternative Title	Laparoscopic 'fast-track' sigmoidectomy for diverticulitis disease in Germany. Results of a prospective quality assurance program
Content Type	Text
Resource Type	Article
Subject	Medicine

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