title: The development of fast-track principles in gynecological surgery.
abstract: Fast-track is a multimodal strategy aimed at reducing the physiological burden of surgery to achieve an enhanced postoperative recovery. The strategy combines unimodal evidence-based interventions in the areas of preoperative preparation, anesthesia, surgical factors and postoperative care. The advantages of fast-track most likely extend to gynecology, although so far have scarcely been reported. This review summarizes current evidence concerning use of fast-track in general and in gynecological surgery. The main findings of this review are that there are benefits within elective gynecological surgery, but studies of quality of life, patient satisfaction and health economics in elective surgery are needed. Studies of fast-track within the field of non-elective gynecological surgery are lacking. Widespread education is needed to improve the rate of implementation of fast-track. Close involvement of the entire surgical team is imperative to ensure a structured perioperative care aiming for enhanced postoperative recovery.
authors.affiliation: Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden. ninnie.borendal.wodlin@lio.se
authors.forename: Ninnie Borendal
authors.initials: NB
authors.lastname: Wodlin
authors.forename: Lena
authors.initials: L
authors.lastname: Nilsson
mesh_terms: D000758:Anesthesia / Q000379:methods; D019317:Evidence-Based Medicine; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods* / Q000639:trends; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000517:prevention & control; D011787:Quality of Health Care; D020127:Recovery of Function; D012307:Risk Factors