title: Fast-track surgery: procedure-specific aspects and future direction.
abstract: BACKGROUND
  Fast-track (FT) surgery can be defined as a coordinated perioperative approach aimed at reducing surgical stress and facilitating postoperative recovery. The objective of this review was to examine the literature on the procedure-specific application of FT surgery.
  
  
  CONCLUSIONS
  The concept of FT rehabilitation has been applied mainly in colorectal surgery, but positive data have appeared also in other areas such as orthopedic, hepatopancreaticobiliary, urological, upper gastrointestinal, gynecological, thoracic, vascular, endocrine, breast, and pediatric surgeries. There is very little experience with comprehensive FT programs in cardiac surgery or trauma. Quantitative analysis from randomized trials and cohort studies suggest that FT is effective in reducing hospital stay without increased adverse events. Other benefits of the FT approach include a reduction in complications, ileus, fatigue, pain, and hospital expenses. However, despite clear benefits of FT care, implementation in daily practice has been slow. Further efforts must be undertaken to secure implementation in routine clinical practice. Standardized FT protocols should be provided on a procedure-specific basis.
authors.affiliation: Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ansari
authors.forename: Luca
authors.initials: L
authors.lastname: Gianotti
authors.forename: Jörg
authors.initials: J
authors.lastname: Schröder
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
mesh_terms: D015331:Cohort Studies; D017046:Cost Savings / Q000191:economics; D019317:Evidence-Based Medicine / Q000191:economics / Q000639:trends; D005858:Germany; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000639:trends*; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000379:methods* / Q000639:trends; D019990:Perioperative Care / Q000191:economics / Q000379:methods* / Q000639:trends; D011183:Postoperative Complications / Q000191:economics / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic