A comparative study of 'fast-track' versus traditional peri-operative care protocols in gastrointestinal surgeries.
BACKGROUND
A 'fast-track protocol' in surgery suggests the application of evidence-based practices to expedite patient recovery. It has shown to reduce hospital stay, hasten recovery as well as facilitate earlier return to work. It has a considerable impact in reducing healthcare costs. The basic tenet is to treat the patient's disease by minimal disturbance of their physiology. The protocol encompasses pre-operative, intra-operative and post-operative interventions which when carried out together would show maximal benefits. The surgeon is usually the leader of the team managing the patient, but it cannot be over-emphasised that this is a multi-disciplinary team approach.


METHODS
We conducted a prospective interventional study to investigate whether 'fast-track' surgery protocols improve patient outcome when compared to traditional peri-operative care followed at our institute. By doing so, we observed that the patients who underwent 'fast tracking' required lesser analgesia, had earlier ambulation, earlier return of intestinal motility, were free from tubes, catheters and drains earlier and lastly were discharged earlier. This was achieved without a rise in complications or re-admissions.


CONCLUSIONS
The results have proved that implementing the fast-track protocol for gastrointestinal surgeries is not only safe and effective, but also improves patient outcome.
Department of General Surgery, L.T.M.G.H., Eastern Expressway, Sion, Mumbai, 400022, India, dradityajnanavati@gmail.com.
Aditya J
AJ
Nanavati
S
S
Prabhakar
D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D002404:Catheterization; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004322:Drainage; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D019990:Perioperative Care / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function; D013997:Time Factors; D016138:Walking / Q000502:physiology; D055815:Young Adult
D000700:Analgesics