Fast-track rehabilitation program and conventional care after esophagectomy: a retrospective controlled cohort study

• Published in: Supportive care in cancer Vol. 21; no. 3; pp. 707 - 714
• Main Authors: Cao, Shouqiang, Zhao, Guibin, Cui, Jian, Dong, Qing, Qi, Sihua, Xin, Yanzhong, Shen, Baozhong, Guo, Qingfeng
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-03-2013; Springer; Springer Nature B.V
• Subjects: Cancer; Cohort Studies; Esophageal cancer; Esophageal Neoplasms - rehabilitation; Esophageal Neoplasms - surgery; Esophagectomy - methods; Esophagus; Female; Hospitalization - statistics & numerical data; Humans; Length of Stay; Male; Medicine; Medicine & Public Health; Middle Aged; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Pain, Postoperative - epidemiology; Patient Satisfaction; Postoperative Complications - epidemiology; Postoperative period; Rehabilitation; Rehabilitation Medicine; Retrospective Studies; Return to Work - statistics & numerical data; Surgery; Time Factors; Postoperative; Esophagectomy; Rehabilitation; Esophageal cancer; Fast track
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-012-1570-0

Purpose
The purpose of this article is to evaluate fast-track rehabilitation program and conventional care after esophagectomy using a retrospective controlled cohort study in esophageal cancer patients.
Methods
Fifty-five patients underwent fast-track rehabilitation program and 57 patients underwent conventional care after esophagectomy. Fast-track rehabilitation program was performed to patients who have early movement, epidural analgesia control, fluid infusion volume control and enteral nutrition for early discharge. The other 57 patients underwent conventional care after esophagectomy. The average of hospital stay and complications were calculated in the patients between the two groups.
Results
The median length of hospital stay in the patients was significantly shorter after fast-track rehabilitation program than after conventional care (7.7 vs 14.8 day,
P
 < 0.01). The percentage of patients who developed complications was significantly lower 30 day after fast-track rehabilitation program than after conventional care (29.1 vs 47.4 %,
P
 < 0.05). 87.3 % in patients of the fast-track rehabilitation program group and 54.4 % in those of the conventional care group reported excellent to very good satisfaction with their pain control (
P
 = 0.000).
Conclusions
The fast-track rehabilitation program results in fewer complications, less postoperative pain, a reduction in the hospital length of stay, and quicker return to work and normal activities after esophagectomy.