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 .
A Propensity Score Matched Analysis of Open Versus Minimally Invasive Transthoracic Esophagectomy in the Netherlands
Objective : The aim of this study was to compare open esophagectomy ( OE ) with minimally invasive esophagectomy ( MIE ) in a population -based setting . Background : R and omized controlled trials and cohort studies have shown that MIE is associated with reduced pulmonary complications and shorter hospital stay as compared to OE . Methods : Patients who underwent transthoracic esophagectomy for cancer between 2011 and 2015 were selected from the national Dutch Upper Gastrointestinal Cancer Audit . Hybrid , transhiatal , and emergency procedures were excluded . Patients who underwent  OE were compared with those treated by MIE . Propensity score matching was used to correct for differences in baseline characteristics . The primary endpoint was postoperative pulmonary complications ; secondary endpoints were morbidity , mortality , convalescence , and pathology . Results : Some 1727 patients were included . After propensity score matching the percentage of patients with 1 or more complications was 62.6 % after OE ( N = 433 ) and 60.2 % after MIE ( N = 433 ) ( P = 0.468 ) . Pulmonary complication rate did not differ between groups : 34.2 % ( OE ) versus 35.6 % ( MIE ) ( P = 0.669 ) . Anastomotic leak ( 15.5 % vs 21.2 % , P = 0.028 ) and reintervention rates ( 21.1 % vs 28.2 % , P = 0.017 ) were higher after MIE . Mortality was 3.0 % in the OE group and 4.7 % in the MIE group ( P = 0.209 ) . Median hospital stay was shorter after MIE ( 14 vs 13 days , P = 0.001 ) . Percentages of R0 resections ( 93 % ) did not differ between groups . The median ( range ) lymph node count was 18 ( 2–53 ) ( OE ) versus 20 ( 2–52 ) ( MIE ) ( P < 0.001 ) . Conclusions : This population -based study showed that mortality and pulmonary complications were similar for OE and MIE . Anastomotic leaks and re interventions were more frequently observed after MIE . MIE was associated with a shorter hospital stay
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 .