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 .
Fast-track surgery improves postoperative clinical recovery and cellular and humoral immunity after esophagectomy for esophageal cancer
Background Our aim was to investigate the influence of FTS on human cellular and humoral immunity using a r and omized controlled clinical study in esophageal cancer patients . Methods Between October 2013 and December 2014 , 276 patients with esophageal cancer in our department were enrolled in the study . The patients were r and omized into two groups : FTS pathway group and conventional pathway group . The postoperative hospital stay , hospitalization expenditure , and postoperative complications were recorded . The markers of inflammatory and immune function were measured before operation as well as on the 1st , 3rd , and 7th postoperative days ( POD ) , including serum level of interleukin-6 ( IL-6 ) , C-reactive protein ( CRP ) , serum globulin , immunoglobulin G ( IgG ) , immunoglobulin M ( IgM ) , immunoglobulin A ( IgA ) and lymphocyte sub population s ( CD3 lymphocytes , CD4 lymphocytes , CD8 lymphocytes and the CD4/CD8 ratio ) in the patients between the two groups . Results In all , 260 patients completed the study : 128 in the FTS group and 132 in the conventional group . We found implementation of FTS pathway decreases postoperative length of stay and hospital charges ( P < 0.05 ) . In addition , inflammatory reactions , based on IL-6 and CRP levels , were less intense following FTS pathway compared to conventional pathway on POD1 and POD3 ( P < 0.05 ) . On POD1 and POD3 , the levels of IgG , IgA , CD3 lymphocytes , CD4 lymphocytes and the CD4/CD8 ratio in FTS group were significantly higher than those in control group ( All P < 0.05 ) . However , there were no differences in the level of IgM and CD8 lymphocytes between the two groups . Conclusions FTS improves postoperative clinical recovery and effectively inhibited release of inflammatory factors via the immune system after esophagectomy for esophageal cancer . Trial registration ChiCTR-TRC-13003562 , the date of registration : August 29 , 2013
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 .