• Ahmed Magheli, Nina Knoll, Michael Lein, Stefan Hinz, Carsten Kempkensteffen, and Oliver Gralla.
• Department of Urology, Charité University Medicine, Campus Mitte, Berlin, Germany. amagheli@gmail.com
• J. Endourol. 2011 Jul 1; 25 (7): 1143-7.

Background And PurposePostoperative recovery of intestinal function, ability to ambulate, and effective pain management are main features to establish an effective fast-track surgery model. We investigated pain scores, ambulation rate, and recovery of intestinal function in a cohort of patients who were undergoing laparoscopic radical prostatectomy (LRP).Patients And MethodsFifty patients who underwent LRP in our institution were randomized to receive either conventional or fast-track postoperative care. Postoperative intestinal function was quantified by clinical signs of intestinal motility. Ambulation data were collected by means of step-count devices. Pain scores were measured by a visual analog scale. Overall satisfaction and additional measures to describe patient satisfaction with the clinical course were used as quality-of-life variables.ResultsFast-track patients had significantly earlier propulsive intestinal motility without increased intestinal complications. Enforced mobilization led to a significantly shorter period to first deflation/defecation. Despite significantly increased ambulation rates in the fast-track group, these patients reported significantly less pain sentience during a significantly shorter hospital stay. Overall satisfaction was significantly higher in the fast-track cohort during the hospital stay.ConclusionWith the implementation of fast-track concepts for LRP, patients can be discharged to home earlier with fewer complications, lower pain scores, and an overall higher satisfaction with life.

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