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Fast track surgery: a clinical audit.

Jonathan Carter¹, Rebecca Szabo, Wee Wee Sim

¹Sydney Gynaecological Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia. jocarter@mail.usyd.edu.au

The Australian & New Zealand Journal of Obstetrics & Gynaecology

|June 5, 2010

Summary

Fast track surgery protocols can reduce hospital stays for abdominal surgery patients. This approach allows for earlier discharge without increasing readmission rates or negatively impacting patient outcomes.

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Area of Science:

Surgical innovation
Patient recovery optimization
Enhanced recovery after surgery (ERAS) protocols

Background:

Fast track surgery (FTS) is a multimodal approach designed to minimize the physiological stress associated with surgical procedures.
Key goals of FTS include reducing length of hospital stay, improving patient outcomes, and accelerating the return to full recovery.

Purpose of the Study:

To assess the efficacy of a peri-operative Fast Track Surgical Protocol (FTSP) in patients undergoing abdominal surgery.
The study aimed to evaluate the impact of FTSP on patient recovery and hospital stay duration.

Main Methods:

A prospective clinical database was utilized to collect data from all patients undergoing laparotomy over a 12-month period.
Retrospective analysis of the collected data was performed to evaluate the FTSP's effectiveness.

Main Results:

The study included 72 patients who underwent laparotomy, with a median length of stay (LOS) of 3.0 days.
Factors independently associated with reduced LOS included early enteral nutrition tolerance, good performance status, COX inhibitor use, and transverse incisions.
Patients managed with FTSP demonstrated a lower LOS compared to non-FTS patients, with no increase in morbidity.

Conclusions:

Fast track surgery enables the discharge of patients with a reduced length of stay.
The FTS approach achieves comparable patient outcomes and does not lead to increased readmission rates when contrasted with traditional surgical pathways.