Allocation | FTS management | Traditional management |
---|---|---|
Computer-generated random numbers | Computer-generated random numbers | |
Pre-operative | ||
Pre-operative assessment, counselling and FT management education | No FT management education | |
Information on the fast-track treatment and informed consent | Information on traditional treatment and informed consent | |
Pre-operative nutritional drink up to 4 h prior to surgery (TPF-D produced by FreseniusKabi Deutschland GmbH, Bad Homburg, Germany). Fasting - solid food 6 h before and liquid food intake of clear fluids 2 h before anaesthesia | Pre-operative fasting at least 8 h | |
Patients do not receive mechanical bowel preparation, only oral intestinal cleaner 12 h pre-operation can be accepted, but no need of liquid stool | Oral bowel preparation or mechanical bowel preparation until liquid stool | |
Anti-microbial prophylaxis and skin preparation | Anti-microbial prophylaxis and skin preparation | |
Pre-operative treatment with carbohydrates (10% glucose 400 ml orally 2–3 h before operation) (patients without diabetes) | No oral intake on the operation day | |
Intra-operative | ||
Avoiding hypothermia, keeping the intra-operative core temperature at 36 ± 0.5 °C | Keeping the intra-operative core temperature at 34.7 ± 0.6 °C | |
Anti-emetics at end of anaesthesia | Not every patient gets anti-emetics at end of anaesthesia | |
Post-operative | ||
Post-operative glycaemic control | Post-operative glycaemic control only with diabetes | |
Preventive post-operative nausea and vomiting (PONV) control | Post-operative nausea and vomiting (PONV) control when it happens | |
Early post-operative diet (3–6 h after surgery, patients resume a liquid diet, 12 h after surgery patients begin to take solid diet) | 6 h after surgery, patients resume a liquid diet, patients begin to take solid diet after anal exhaust | |
Early mobilisation | Early mobilisation | |
Time to drain removal less than 24 h (eliminate post-operative bleeding and urinary fistula, intestinal fistula) | Time to drain removal less than 48 h (eliminate post-operative bleeding and urinary fistula, intestinal fistula) | |
Audit | Systematic audit improves compliance and clinical outcomes |