الفهرس 
Perioperative Stress Affecting Patients Undergoing GITOnly 14 pages are availabe for public view
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Abstract
Background: Successful care of post-operative patient is dependent on optimal nutritional supports which enhance wound healing and immune response. A poor post-operative nutritional state is associated with reduction of muscle function, respiratory function, immune function, impaired wound healing and increase post-operative wound complication. The aim of this work was to evaluate the outcome of early oral feeding, balanced analgesia and enforced mobilization which are integral parts of fast track rehabilitation program versus delayed oral feeding and regular forms of mobilization and pain control in patients underwent colorectal surgery. Patients and Methods: The present study included Sixty patients were admitted to the Gastrointestinal Surgery Unit, Alexandria Military Hospital and Ein Shams University Hospital. All submitted to urgent or elective colorectal surgery due to different reasons either benign and malignant conditions e.g. colorectal cancer and trauma. Results: The present study revealed that postoperative hospital stay ranged between (3-10) days with mean length of stay 4.2± 1.56 days while in group (B) the range of postoperative hospital stay was (6 -14 ) with mean of 8.4 ± 1.6 days with statistically significant difference between the two groups. Conclusion: Early oral feeding is safe and tolerable after colorectal surgery with no increase in postoperative morbidity and mortality. Epidural analgesia is more effective method for postoperative pain control than conventional systemic analgesia. Enforced mobilization protocol helps patients to get early rehabilitation. The main achievement of enhanced recovery program is the considerable reduction in hospital stay with its physical, psychological and economic benefits. Recommendations: There are many barriers coming into the way of accepting the enhanced recovery program mainly lack of awareness and lack of belief that it can actually be safely done. The other barriers include (time limitation, unavailability of outcome data, insufficient expertise or staff support) therefore a need to provide adequate awareness and education about the technique to overcome the previously mentioned barriers and implement this protocol. Most of the previous studies were performed on elective colonic surgery mainly colonic cancer, so we have to perform other studies on larger numbers of patients undergoing emergency and elective colorectal surgery to confirm the results of the present study.
Key words: on optimal nutritional, fast track rehabilitation program, delayed oral feeding