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document
Prospective randomized controlled trial to evaluate " fast-track " elective open infrarenal aneurysm repair . BACKGROUND AND AIMS Fast-track programs have been introduced in many surgical fields to minimize postoperative morbidity and mortality . Morbidity after elective open infrarenal aneurysm repair is as high as 30 % ; mortality ranges up to 10 % . In terms of open infrarenal aneurysm repair , no randomized controlled trials exist to introduce and evaluate such patient care programs . MATERIALS AND METHODS This study involved prospective randomization of 82 patients in a " traditional " and a " fast-track " treatment arm . Main differences consisted in preoperative bowel washout ( none vs. 3 l cleaning solution ) and analgesia ( patient controlled analgesia vs. patient controlled epidural analgesia ) . Study endpoints were morbidity and mortality , need for postoperative mechanical ventilation , and length of stay ( LOS ) on intensive care unit ( ICU ) . RESULTS The need for assisted postoperative ventilation was significantly higher in the traditional group ( 33.3 % vs. 5.4 % ; p = 0.011 ) . Median LOS on ICU was shorter in the fast-track group , 41 vs. 20 h. The rate of postoperative medical complications was significantly lower in the fast-track group , 16.2 % vs. 35.7 % ( p = 0.045 ) . CONCLUSION We introduced and evaluated an optimized patient care program for patients undergoing open infrarenal aortic aneurysm repair which showed a significant advantage for " fast-track " patients in terms of postoperative morbidity .
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Intervention_Physical
" fast-track " elective open infrarenal aneurysm repair
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Intervention_Physical
fast-track
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Intervention_Physical
preoperative bowel washout
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Intervention_Educational
patient care program
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Outcome_Other
postoperative morbidity
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Outcome_Mortality
mortality
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Outcome_Physical
Morbidity
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Outcome_Physical
mortality
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Outcome_Physical
morbidity
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Outcome_Mortality
mortality
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Outcome_Other
need for postoperative mechanical ventilation
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Outcome_Other
length of stay ( LOS ) on intensive care unit ( ICU )
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Outcome_Other
assisted postoperative ventilation
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Outcome_Other
Median LOS on ICU
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Outcome_Adverse-effects
rate of postoperative medical complications
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Outcome_Physical
postoperative morbidity