Fast-track surgery of the colon in children.

Mattioli, Girolamo; Palomba, Loredana; Avanzini, Stefano; Rapuzzi, Giovanni; Guida, Edoardo; Costanzo, Sara; Rossi, Valentina; Basile, Angela; Tamburini, Silvana; Callegari, Marina; DellaRocca, Mirta; Disma, Nicola; Mameli, Leila; Montobbio, Giovanni; Jasonni, Vincenzo

INTRODUCTION The aim of this study is to present the "fast-track" experience in children who underwent colon resection. MATERIALS AND METHODS Forty-six children who underwent laparoscopic colon resection were prospectively included in the study. Anomalies of colon innervation and inflammatory bowel disease represented the main surgical indications. RESULTS Left colon/sigmoid resection was performed in 37, total colon resection was done in 5, and right colon resection in 4 children. Total colon resection was always associated to ileostomy. Anastomosis was performed in 41 cases. Patients were postoperatively monitored for pain, return to normal activity, feeding, bowel movements, and complications. Stool passage and oral feeding were started on postoperative day 1, and all patients were discharged before postoperative day 4. One child was readmitted the day after discharge because of an anastomotic leak. No other major complications were recorded. DISCUSSION Minimally invasive surgery is safe and effective in pediatric colonic surgery and allows a fast recovery time (fast-track).