Laparoscopic rectal resections and fast-track surgery: what can be expected?

BACKGROUND: We present the results of combining protocols of standardized laparoscopic rectal resection (LRR) and perioperative fast track care. METHODS: Patients undergoing LRRs were identified from a prospectively maintained, institutional review board-approved database. Perioperative fast track care and laparbscopic operations were performed according to a standardized system. RESULTS: Thirty-seven patients were included. Conversion was performed in 2 males (5%). The mean operative time was 184 minutes (range 109 to 410 minutes). The mean hospital stay was 3.0 days (range I to 8 days) with 90% of patients discharged less than 5 days after surgery. No anastomotic leaks or mortality occurred and the in-hospital complications rate was 8%. Readmission occurred in 3 patients (8%). No specimen had involved distal or circumferential resection margins. CONCLUSIONS: LRRs can be performed safely and effectively for rectal pathologies. Laparoscopy in conjunction with modem perioperative care provides rapid recovery with efficient use of hospital resources. (c) 2009 Published by Elsevier Inc.