Fast-track colorectal surgery program reduces hospital length of stay.

PURPOSE: This study compared outcomes of a fast-track postoperative program implemented for patients undergoing laparoscopic colorectal surgery on 2 surgical units to patients receiving traditional postoperative care following laparoscopic colorectal surgery prior to implementation of the fast-track program. AIMS: The primary aim was to determine if there was a significant difference in length of stay and 30-day readmission rates between the 2 groups. The secondary aim was to examine whether patients on the fast-track program were able to successfully tolerate early diet, early ambulation, and minimal use of drains. SETTING: The study was conducted at a large Midwestern hospital. METHOD: A retrospective medical record review was done on 100 patients who underwent laparoscopic colorectal surgery on the fast-track program for data pertaining to the research questions. Additionally, a medical record review was done for comparison on 100 matched controls based on age, sex, surgeon, and surgical procedure who received traditional postoperative care following laparoscopic colorectal surgery. FINDINGS: A statistical significant difference of 1 day was found between patients receiving traditional care and patients on the fast-track program. Readmission rates between the 2 groups were not statistically significantly different. CONCLUSION: : Overall, patients undergoing laparoscopic colorectal surgery on a fast-track program discharged 1 day sooner than patients on traditional recovery programs. Patients successfully followed the fast-track program. IMPLICATIONS: Fast-track programs in colorectal surgery reduce length of stay and could be considered for other surgical populations.

Providing holistic care to bariatric patients.

Bariatric patients often encounter challenging physical environments and sometimes encounter negative attitudes from health professionals when seeking care. Most facilities have the basic equipment needed to care for these patients. Using ceiling lifts or limb slings to facilitate repositioning or transfer has benefits for patients and staff. Environment, equipment, education, and resources are important to providing sensitive, respectful, safe, and high-quality patient care. This column describes strategies to promote holistic care for the bariatric population.

Pseudomyxoma peritonei syndrome of appendiceal origin: an overview.

Pseudomyxoma peritonei (PMP) syndrome is an uncommon, slowly progressive condition that usually arises from perforation of an adenoma in the appendix. PMP syndrome is characterized by mucin accumulation in the peritoneal cavity. Mucinous implants are found on all peritoneal surfaces and the omentum. PMP syndrome rarely metastasizes outside the abdominal cavity but remains a fatal illness as the space in the abdomen and pelvis required for normal function of the gastrointestinal tract becomes filled with copious amounts of the mucinous tumor. Treatment options include observation, aggressive debulking surgery, intraperitoneal chemotherapy, radiotherapy, and mucolytic agents.