Document Detail


Accelerated postoperative recovery programme after colonic resection improves physical performance, pulmonary function and body composition.
MedLine Citation:
PMID:  11952586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Postoperative organ dysfunction contributes to morbidity, hospital stay and convalescence. Multimodal rehabilitation with epidural analgesia, early oral feeding, mobilization and laxative use after colonic resection has reduced ileus and hospital stay. METHODS: Fourteen patients receiving conventional care (group 1) and 14 patients who had multimodal rehabilitation (group 2) were studied before and 8 days after colonic resection. Outcome measures included postoperative mobilization, body composition by whole-body dual X-ray absorptiometry, cardiovascular response to treadmill exercise, pulmonary function and nocturnal oxygen saturation. RESULTS: Defaecation occurred earlier (median day 1 versus day 4) and hospital stay was shorter (median 2 versus 12 days) in patients who had multimodal treatment. Lean body and fat mass decreased in group 1 but not in group 2. Exercise performance decreased by 44 per cent in group 1 but was unchanged in group 2. A postoperative increase in heart rate (HR) response to exercise was avoided in group 2. Pulmonary function decreased in group 1 but not in group 2. There was less nocturnal postoperative hypoxaemia in group 2. Cardiac demand-supply (HR/oxygen saturation ratio) increased in group 1 but not in group 2. CONCLUSION: Multimodal rehabilitation prevents reduction in lean body mass, pulmonary function, oxygenation and cardiovascular response to exercise after colonic surgery.
Authors:
L Basse; H H Raskov; D Hjort Jakobsen; E Sonne; P Billesbølle; H W Hendel; J Rosenberg; H Kehlet
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  89     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-15     Completed Date:  2002-05-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  446-53     Citation Subset:  AIM; IM    
Affiliation:
Department of Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Aged
Body Composition
C-Reactive Protein / analysis
Colonic Diseases / surgery*
Early Ambulation
Exercise Tolerance
Fatigue / etiology
Forced Expiratory Volume / physiology
Humans
Length of Stay
Middle Aged
Nausea / etiology
Oxygen Consumption
Pain, Postoperative / etiology
Postoperative Complications / etiology*
Prospective Studies
Serum Albumin / analysis
Vital Capacity / physiology
Chemical
Reg. No./Substance:
0/Serum Albumin; 9007-41-4/C-Reactive Protein

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