A pattern of consistent evolution in fast-track protocol s was clearly demonstrated and these have shown variations in the core-identified components across the studies .
In the future incremental gains through focused improvements in key components will lend itself to even better postoperative outcomes and patient experience during oesophageal cancer treatment
Fast track is a st and ardised goal directed patient 's care pathway that aims to facilitate recovery following surgery .
Currently , there are large variations in the fast track protocol s used in oesophagectomy due to the complexity of the procedure .
The objective of this systematic review is to assess the evolution of fast track protocol s  following oesophagectomy  since its implementation and the result ing effect on postoperative outcomes .
Omission of Nasogastric Tube Application in Postoperative Care of Esophagectomy
Introduction Surgeons routinely use nasogastric ( NG ) tubes in most esophageal resection surgeries . Considering the numerous complications caused by using the tube and the uncertainty about its usefulness and the scarcity of studies conducted on the subject , particularly in patients with esophageal cancer , the necessity of using the tube in these types of cases is investigated in the present study . Methods In this clinical trial , patients with esophageal cancer were r and omized into groups with NG tube and without NG tube after surgery ; the latter were prescribed Metoclopramide , as well . The variables recorded for each patient included the first day of gas passage , defecation and bowel sounds ( BSs ) auscultation , as well as the duration of postoperative hospitalization , nausea and vomiting , abdominal distension , pulmonary complications , wound complications , anastomosis leak , and the need for placing/replacing the NG tube . Results The incidence of anastomosis leak was significantly higher in the NG-tube group ( 6 vs. 0 ; P = 0.016 ) . Other complications were not different in the two groups . The mean time of gas passage , defecation , BS auscultation , and the duration of postoperative hospitalization did not have meaningful differences in the two groups . The need for placing/replacing the NG tube was the same for both groups . Conclusions The routine application of NG tubes after surgery is not recommended for all patients . We suggest that NG tubes should be used according to the specific problems of each patient
A pattern of consistent evolution in fast-track protocol s was clearly demonstrated and these have shown variations in the core-identified components across the studies .
In the future incremental gains through focused improvements in key components will lend itself to even better postoperative outcomes and patient experience during oesophageal cancer treatment
Fast track is a st and ardised goal directed patient 's care pathway that aims to facilitate recovery following surgery .
Currently , there are large variations in the fast track protocol s used in oesophagectomy due to the complexity of the procedure .
The objective of this systematic review is to assess the evolution of fast track protocol s  following oesophagectomy  since its implementation and the result ing effect on postoperative outcomes .