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December 12, 2019

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Fast Track Surgery and Enhanced Recovery Protocols

June 1, 2015

As a multi-surgery patient, I've got to say, this makes me very angry!


"the concept of the "fast-track methodology" has uniformly provided a major enhancement in recovery leading to decreased hospital stay and with an apparent reduction in medical morbidity but unaltered "surgery-specific" morbidity in a variety of procedures. However, despite being based on a combination of evidence-based unimodal principles of care, recent surveys have demonstrated slow adaptation and implementation of the fast-track methodology."


From Evidence-based surgical care and the evolution of fast-track surgery.


Why isn't all surgery "fast tracked" with "enhanced recovery protocols?"


And here is the one paper specific to esophagectomies:

Use of a fast-track surgery protocol on patients undergoing minimally invasive oesophagectomy: preliminary results


And here is the biggest joke (and the joke would have been on me had I not been very knowledgeable in this area): a comparison of "fast track" with "conventional."


Notice this: Nutritional support is the first thing listed (after explaining what fast track means)! 


And, of course, this is paper is from China, not the "Western world." Pathetic!


And this study, Preoperative inspiratory muscle training to prevent postoperative pulmonary complications in patients undergoing esophageal resection (PREPARE study): study protocol for a randomized controlled trial. discusses inspiratory muscle exercise to prevent pneumonia. You've just got to wonder why this is not an automatic. Ask for it!


Be armed with knowledge and take action with that knowledge!


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