Fast-track surgery improves postoperative outcomes after hepatectomy.

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Enhanced Recovery Pathways

Background:

• Fast-track (FT) programs are established in colorectal surgery but their role in liver surgery remains under-investigated.
• Hepatocellular carcinoma (HCC) surgery requires optimized perioperative management to improve patient outcomes.

Purpose of the Study:

• To evaluate the safety and efficacy of fast-track (FT) programs in patients undergoing hepatectomy for hepatocellular carcinoma.
• To compare perioperative outcomes between FT and non-FT (NFT) groups in liver surgery.

Main Methods:

• A prospective study randomized 297 hepatocellular carcinoma patients into FT (n=135) and NFT (n=162) groups.
• Perioperative management strategies were compared between the two groups.
• Correlation analyses were performed to identify predictors of recovery time.

Main Results:

• The FT group demonstrated significantly reduced operation time, anhepatic phase, and intraoperative blood loss.
• First exhaust time and hospital stay were significantly shorter in the FT group.
• FT postoperative management was the sole predictor for shorter first exhaust time and hospital stay.
• No significant differences in postoperative complications, readmission, or mortality were observed between groups.

Conclusions:

• Fast-track programs are safe and effective in hepatectomy for hepatocellular carcinoma.
• Implementation of FT programs can lead to improved perioperative efficiency and patient recovery.
• Further research may explore broader application of FT protocols in complex liver resections.