Laparoskopische "Fast-track"-Sigmaresektion bei Divertikulitis in Deutschland. Ergebnisse einer prospektiven Qualitätssicherungsmassnahme
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Laparoskopische "Fast-track"-Sigmaresektion bei Divertikulitis in Deutschland. Ergebnisse einer prospektiven Qualitätssicherungsmassnahme. / Tsilimparis, N; Haase, O; Wendling, P; Kipfmüller, K; Schmid, M; Engemann, R; Schwenk, W.
in: DEUT MED WOCHENSCHR, Jahrgang 135, Nr. 36, 01.09.2010, S. 1743-8.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Laparoskopische "Fast-track"-Sigmaresektion bei Divertikulitis in Deutschland. Ergebnisse einer prospektiven Qualitätssicherungsmassnahme
AU - Tsilimparis, N
AU - Haase, O
AU - Wendling, P
AU - Kipfmüller, K
AU - Schmid, M
AU - Engemann, R
AU - Schwenk, W
N1 - Copyright Georg Thieme Verlag KG Stuttgart . New York.
PY - 2010/9/1
Y1 - 2010/9/1
N2 - BACKGROUND AND OBJECTIVE: The natural course of sigmoid colon diverticulitis during conservative therapy and the assessment of the perioperative morbidity after sigmoid colon resection are differently evaluated by surgeons and gastroenterologists. The "fast-track" rehabilitation accelerates the reconvalescence and reduces the rate of postoperative general complications after colorectal surgery. The results of the laparoscopic "Fast-track" sigmoidectomy should be examined within a quality assurance program to better evaluate the perioperative risks following surgical management of diverticulitis.PATIENTS AND METHODS: A prospective data collection within the voluntary quality assurance program "fast-track" Kolon II was performed. All participating clinics agreed on a multimodal, evidence-based standard perioperative treatment in terms of a "fast-track" rehabilitation for elective operations for sigmoid diverticulitis.RESULTS: Data from 846 patients undergoing laparoscopic "fast-track" sigmoid colon resection in 23 surgical departments in Germany were collected and evaluated. The mean age of the patients was 63 years (range 23 - 91). 203 patients (24 %) had severe co-morbidities (ASA classification III - IV). A conversion to conventional open surgery was necessary in 51 cases (6 %). Complications occurred in 93 patients (11 %). 76 patients suffered a surgical complication (8.9 %) and 32 patients (3.8 %) a general complication. Two patients died postoperatively due to multi-organ failure following anastomotic leaks. The patients took solid food in median on day 1 after surgery (range, 0 - 5) and passed stool on day 2 (range, 0 - 22). Predefined discharge criteria (free of pain on oral medication, normal oral feeding, stool) were met on day 4 (range, 1 - 58) and the patients were discharged on day 7 (range, 3 - 72). The 30-day re-admission rate was 3.9 %.CONCLUSION: Patients undergoing laparoscopic "fast-track" sigmoidectomy had a low rate of general complications and had a rapid reconvalescence with a short postoperative in-patient treatment as documented in a german quality assurance program.
AB - BACKGROUND AND OBJECTIVE: The natural course of sigmoid colon diverticulitis during conservative therapy and the assessment of the perioperative morbidity after sigmoid colon resection are differently evaluated by surgeons and gastroenterologists. The "fast-track" rehabilitation accelerates the reconvalescence and reduces the rate of postoperative general complications after colorectal surgery. The results of the laparoscopic "Fast-track" sigmoidectomy should be examined within a quality assurance program to better evaluate the perioperative risks following surgical management of diverticulitis.PATIENTS AND METHODS: A prospective data collection within the voluntary quality assurance program "fast-track" Kolon II was performed. All participating clinics agreed on a multimodal, evidence-based standard perioperative treatment in terms of a "fast-track" rehabilitation for elective operations for sigmoid diverticulitis.RESULTS: Data from 846 patients undergoing laparoscopic "fast-track" sigmoid colon resection in 23 surgical departments in Germany were collected and evaluated. The mean age of the patients was 63 years (range 23 - 91). 203 patients (24 %) had severe co-morbidities (ASA classification III - IV). A conversion to conventional open surgery was necessary in 51 cases (6 %). Complications occurred in 93 patients (11 %). 76 patients suffered a surgical complication (8.9 %) and 32 patients (3.8 %) a general complication. Two patients died postoperatively due to multi-organ failure following anastomotic leaks. The patients took solid food in median on day 1 after surgery (range, 0 - 5) and passed stool on day 2 (range, 0 - 22). Predefined discharge criteria (free of pain on oral medication, normal oral feeding, stool) were met on day 4 (range, 1 - 58) and the patients were discharged on day 7 (range, 3 - 72). The 30-day re-admission rate was 3.9 %.CONCLUSION: Patients undergoing laparoscopic "fast-track" sigmoidectomy had a low rate of general complications and had a rapid reconvalescence with a short postoperative in-patient treatment as documented in a german quality assurance program.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Colon, Sigmoid
KW - Diverticulitis, Colonic
KW - Evidence-Based Medicine
KW - Female
KW - Germany
KW - Humans
KW - Male
KW - Middle Aged
KW - Postoperative Complications
KW - Prospective Studies
KW - Quality Control
KW - Sigmoidoscopy
KW - Young Adult
U2 - 10.1055/s-0030-1263305
DO - 10.1055/s-0030-1263305
M3 - SCORING: Zeitschriftenaufsatz
C2 - 20812161
VL - 135
SP - 1743
EP - 1748
JO - DEUT MED WOCHENSCHR
JF - DEUT MED WOCHENSCHR
SN - 0012-0472
IS - 36
ER -