A Prospective Randomized Trial Comparing Traditional and Fast‐Track Patient Care in Elective Open Infrarenal Aneurysm Repair

Abstract

An optimized patient care program in open infrarenal aortic aneurysm repair shows favorable results concerning need for postoperative assisted mechanical ventilation, time to full enteral feeding, and incidence of medical complications. Further ranomized multicentric trials are necessary to justify broad implementation (clinical trials. gov identifier NCT 00615888).

Fast-Track Programs Versus Traditional Care in Hepatectomy: A Meta-Analysis of Randomized Controlled Trials

“…Over the last decade, FT programs have been used in vascular surgery [5], breast surgery [6], urologic [7], and orthopedic surgery [8]. However, FT for liver surgery was first described in 2008 [9].…”

Surgical intensive care unit – essential for good outcome in major abdominal surgery?

“…Similar conclusions were drawn from case series of patients undergoing esophagectomy with early mobilization within a fast-track protocol [51,53]. Prospective randomized controlled trials evaluating early mobilization as part of a fast-track protocol are currently available for elective open abdominal aortic aneurysm repair [59] and open colonic surgery [60]. They indicate that this multimodal concept may not only reduce the length of hospital stay, but also postoperative complications.…”

“…Whereas liberal fluid regimens were a common practice in abdominal surgery, more restrictive approaches have recently been suggested and evaluated [72], particularly as part of fast-track protocols [53,54,59,60]. In a prospective randomized trial in abdominal surgery with intraoperative restrictive versus liberal fluid management (total median volume 1,230 ml versus 3,670 ml, p<0.001) and no difference in postoperative fluid volume, the fluid-restricted group had fewer postoperative complications [73].…”

Current perioperative practice in Canadian vascular surgery

“…1 As the evidence supporting updated perioperative management builds, a gap has developed between actual practice and the established best practice from the literature. This gap is evident in a variety of common perioperative management principles.…”