Fast-track Surgery After Gynecological Oncology Surgery
Condition: Length of Stay; Postoperative Complications; CRP
MeSH terms: Postoperative Complications
Study type: Interventional

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.
    

Detailed description: 
      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.
    

Intervention name(s): pre-operative assessment, counseling and education; Preoperative nutritional drink up to 4 h prior to surgery; bowel preparation; preoperative treatment with carbohydrates; fast solid; avoiding hypothermia; Postoperative glycaemic control; postoperative nausea and vomiting (PONV) control;; early postoperative diet; pre-operative fasting at least 8h; bowel preparation for traditional surgery; began to take solid diet after anal exhaust
Intervention type(s): Procedure; Procedure; Procedure; Procedure; Procedure; Procedure; Procedure; Procedure; Procedure; Procedure; Procedure; Procedure
Intervention description(s): pre-operative assessment, counseling and FT management education; Preoperative nutritional drink up to 4 h prior to surgery mechanical bowl preparation should not be used; patients are not received mechanical bowel preparation, only oral intestinal cleaner 12 h pre-operation can be accepted, but no need of liquid stool; preoperative treatment with carbohydrates (patients without diabetes).; fast solid food before 6 h and liquid food Intake of clear fluids 2 h before anaesthesia;; avoiding hypothermia, keeping the intra-operative lowtemperature at 36 ±0.5 degree centigrade; antiemetics at end of anaesthesia.; Postoperative glycaemic control;; early postoperative diet(3-6 h after surgery, patients resumed a liquid diet, 12 h after surgery patients began to take solid diet).; Oral bowel preparations or mechanical bowl until liquid stool; 6 h after surgery, patients resumed a liquid diet, patients began to take solid diet after anal exhaust
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: prospective randomised controlled trial
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Fast-track surgery; Gynecological oncology; Hospitalization post-operation; Complication