TITLE:
A 5-Year Review of Gynaecological Oncology Patients Managed by a Fast Track Surgery Program
AUTHORS:
Jonathan Carter, Shannon Philp, Rachel O’Connell
KEYWORDS:
Fast Track Surgery; Enhanced Recovery; Optimized Recovery
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.5 No.1,
January
15,
2014
ABSTRACT: Introduction: The aim of this study is to provide
a comprehensive 5-year audit of patients undergoing laparotomy for suspected or
confirmed gynaecological malignancy to document the frequency and incidence of
adverse events and to investigate factors associated with shorter length of
stay and readmission to hospital. Methods: A 5-year surgical audit of the
period commencing 2008 and concluding 2012. All patients undergoing laparotomy
were included in the audit without exclusions. Approval was granted by the
local Ethics Review Committee. Results: Four hundred and twenty-seven patients
underwent laparotomy for suspected or confirmed gynaecological malignancy and
were managed by Fast Track Surgery (FTS) principles. Average age was 54.8 years
and average weight and BMI were 73.4 kg and 28.1 respectively. Ultimately 254
(59%) patients had confirmed malignancy. Average surgery duration was 2.36
hours and average estimated blood loss (EBL) at surgery was 262 mL. Median and
mean LOS was 3.0 and 3.5 days respectively with 125 (29%) patients discharged
on day 2. Overall transfusion rate was 5%. Other adverse events in decreasing
frequency were hospital readmission (3.7%), significant wound infection (3%)
and unplanned High Dependency Unit (HDU) admission (1.4%). All other adverse
events were uncommon with rates