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Ann Chir ; 130(10): 608-12, 2005 Dec.
Artigo em Francês | MEDLINE | ID: mdl-16043115

RESUMO

INTRODUCTION: The postoperative hospital stay after colorectal resection is about 15 days in France, when some authors have published a postoperative stay of 2 to 5 days. The aim of this work was to obtain a postoperative hospital stay less than 7 days. PATIENTS AND METHODS: Sixty-one patients who underwent a colorectal resection performed by laparotomy were included in the study: 16 right hemicolectomies, 9 left hemicolectomies, 15 sigmoidectomies and 21 anterior resections were performed. The operation was performed through a midline incision extended over the umbilicus in 13 cases, limited below the umbilicus in 22 cases and elective in 26 cases (right transverse in 16 and left iliac fossa in 10 cases). The protocol comprised epidural analgesia or wound infusion with ropivacaine, restricted intravenous fluids, early oral feeding and active mobilisation. RESULTS: The median and mean times of discharge were 6 and 7.3 days respectively; 36 patients (59%) were discharged on postoperative days 3 to 6, 8 patients (13%) on days 7 and 17 (28%) after day 7. A nasogastric tube was necessary in 2 cases (3.3%). Ten (16%) postoperative complications and 3 (5%) readmissions occurred. There were no deaths. CONCLUSION: Although the postoperative stay cannot be reduced in all the cases, a median hospital stay inferior to which is currently observed can easily be obtained by applying some simple and inexpensive means. This is advantageous for the patient, whose recovery is faster, and contributes to reduce the cost, which is of crucial importance today.


Assuntos
Colectomia/reabilitação , Colo/cirurgia , Tempo de Internação , Complicações Pós-Operatórias , Reto/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Amidas/uso terapêutico , Analgesia Epidural , Anestésicos Locais/uso terapêutico , Estudos de Coortes , Feminino , Hidratação , Humanos , Laparotomia , Masculino , Pessoa de Meia-Idade , Movimento , Readmissão do Paciente , Ropivacaina , Cicatrização
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