fast-track surgery after gynecological oncology surgery

Conditions: Length of Stay; Postoperative Complications; CRP

Summary: fast-track surgery (fts) pathway, also known as enhanced recovery after surgery (eras), fts is a multidisciplinary approach aiming to accelerate recovery, reduce complications, minimize hospital stay without an increased readmission rate and reduce healthcare costs, all without compromising patient safety. it has been used successfully in non-malignant gynecological surgery, but it has been proven to be especially effective in elective colorectal surgery. however, no consensus guideline has been developed for gynecological oncology surgery although surgeons have attempted to introduce slightly modified fts programmes for patients undergoing such surgery. no randomised controlled trials for now. the advantages of fast-track most likely extend to gynecology, although so far have scarcely been reported. there is a existing research showed fts in gynecological oncology provide early hospital discharge after gynaecological surgery meanwhile with high levels of patient satisfaction. the aim of this study is to identify patients following a fts program who have been discharged earlier than anticipated after major gynaecological/gynaecological oncologic surgery and analyze the complication after surgery.

methods/design comparison of fast-track (ft) and traditional management protocols. the primary endpoints is length of hospitalization post-operation (d, mean±sd). it was calculated by the difference between date of discharge and date of surgery. the secondary endpoints are complications in both groups are assessed during the first 21 days postoperatively. including infection(wound infection, lung infection, intraperitoneal infection, operation space infection), postoperative nausea and vomiting (ponv) , ileus, postoperative hemorrhage, postoperative thrombosis and apache ii score. the advantages of fast-track most likely extend to gynecology, although so far have scarcely been reported. no randomised controlled trials for now. the aim of this study is to compare the los (length of hospitalization post-operation) after the major gynaecological/gynaecological oncologic surgery and analyze the complication after surgery. this trial can show whether the fts program can achieve early hospital discharge after gynaecological surgery meanwhile with low levels of complications.

Eligibility criteria:
inclusion criteria: 1. patients scheduled for gynecological oncology surgery(including radical hysterectomy add lymphadenectomy, hysterectomy add lymphadenectomy and cytoreductive) 2. aged 18 years or older 3. signed informed consent provided exclusion criteria: 1. patients with a documented infection at the time of operation 2. aged 71 years or older 3. patients with ileus at the time of operation 4. patients with hypocoagulability 5. patients with psychosis, alcohol dependence or drug abuse history 6. patients with primary nephrotic or hepatic disease 7. patients with severe hypertension systolic pressure≥160mmhg, diastolic pressure\>90mmhg

Keywords: fast-track surgery gynecological oncology hospitalization post-operation complication