The development of fast-track principles in gynecological surgery

Authors

  • NINNIE BORENDAL WODLIN,

    1. Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping and Department of Obstetrics and Gynecology, County Council of Östergötland, Linköping
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  • LENA NILSSON

    1. Division of Drug Research, Anesthesiology and Intensive Care, Department of Medical and Health Sciences, Linköping University and Department of Anesthesia and Intensive Care, County Council of Östergötland, Linköping, Sweden
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  • Conflict of interest The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Ninnie Borendal Wodlin, Department of Obstetrics and Gynecology, University Hospital, S-581 85 Linköping, Sweden. E-mail: ninnie.borendal.wodlin@lio.se

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.

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