Langenbeck's Archives of Surgery

, Volume 398, Issue 1, pp 29–37

Fast-track surgery: procedure-specific aspects and future direction

  • Daniel Ansari
  • Luca Gianotti
  • Jörg Schröder
  • Roland Andersson
Review Article

DOI: 10.1007/s00423-012-1006-9

Cite this article as:
Ansari, D., Gianotti, L., Schröder, J. et al. Langenbecks Arch Surg (2013) 398: 29. doi:10.1007/s00423-012-1006-9

Abstract

Introduction

Fast-track (FT) surgery can be defined as a coordinated perioperative approach aimed at reducing surgical stress and facilitating postoperative recovery. The objective of this review was to examine the literature on the procedure-specific application of FT surgery.

Discussion

The concept of FT rehabilitation has been applied mainly in colorectal surgery, but positive data have appeared also in other areas such as orthopedic, hepatopancreaticobiliary, urological, upper gastrointestinal, gynecological, thoracic, vascular, endocrine, breast, and pediatric surgeries. There is very little experience with comprehensive FT programs in cardiac surgery or trauma. Quantitative analysis from randomized trials and cohort studies suggest that FT is effective in reducing hospital stay without increased adverse events. Other benefits of the FT approach include a reduction in complications, ileus, fatigue, pain, and hospital expenses. However, despite clear benefits of FT care, implementation in daily practice has been slow. Further efforts must be undertaken to secure implementation in routine clinical practice. Standardized FT protocols should be provided on a procedure-specific basis.

Keywords

Fast-track surgery Enhanced recovery after surgery ERAS Perioperative care Implementation Evidence-based medicine 

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Daniel Ansari
    • 1
  • Luca Gianotti
    • 2
  • Jörg Schröder
    • 3
  • Roland Andersson
    • 1
  1. 1.Department of Surgery, Clinical Sciences Lund, Lund UniversitySkåne University HospitalLundSweden
  2. 2.Department of Surgery, Milano-Bicocca UniversitySan Gerardo HospitalMonzaItaly
  3. 3.Department of SurgeryMarien-KrankenhausBergisch GladbachGermany

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