Fast-Track in der Rektumchirurgie – klinische Ergebnisse eines therapeutischen Konzepts [thesis]

Marian Sascha Krempeć, Universitätsbibliothek Der FU Berlin, Universitätsbibliothek Der FU Berlin
2020
Every year more than 20 000 people in Germany contract rectal cancer. In many cases, after a confirmed diagnosis, a surgical procedure with several days of hospitalization and a lengthy convalescence phase takes place. Despite the most modern medical possibilities, there is a considerable risk of complications. In the 1990s, Professor Kehlet and his team developed a multimodal, interdisciplinary therapy concept. The so-called fast-track-surgery allows a perioperative management which improves
more » ... nt which improves the structural process and leads to a reduction of complications and an accelerated recovery. Methods: It is shown how the integration of such a therapy concept into the daily clinical routine has an effect on the patient's well-being or the postoperative outcome. For this purpose, 118 patients undergoing elective rectal resection in the transitional period (2009-2011) after the introduction of the -fast-track-surgery and laparoscopy were retrospectively examined. For further evaluation, preoperative risk markers and postoperative complications, both general and surgical, were recorded. The patient population were divided into two groups (Laparoscopically operated and conventionally operated patients). The evaluation was done comparatively between the groups as well as comparatively between the different years The aim of the work is to show that after the introduction of a "fast-track" treatment concept, a reduction of complications in the field of rectal surgery can be achieved. Furthermore, the differences between laparoscopic interventions and conventional interventions are investigated. Results: The introduction of a fast-track-therapy concept and laparoscopy shows a reduction of complications and an accelerated convalescence in the comparison of the two groups. This results in an improved outcome for the patient through the introduction of a multimodal therapy concept. However, the combined effect of fast-track and laparoscopic interventions as well as possible selection bias of the comparison groups are problematic.
doi:10.17169/refubium-27219 fatcat:jrannhrjungjrdx4muagdf6e6u