Evolution of the fast track process in oesophageal surgery
The fast track process is a directed surgical care pathway with the goal to improve patient recovery following surgery. The implemented fast track protocols in oesophageal surgery were adopted from approved protocols of other surgical disciplines, resulting in large variation of the used protocols. The published studies have clearly demonstrated the consistent evolution in fast track protocols with showing variations in the protocol components across the published reports. However, an overall improvement in hospital stay length, anastomotic leak, pulmonary complications and mortality has been showed over time without influencing the surgical morbidity. Therfore, these positive results in outcomes demonstrated the feasibility of the fast track process without supplementary risk in oesophageal surgery. The variations in the fast track protocols and key components applied following oesophagectomy identify the real need to continually assessing and identifying the areas of improvement. The objective of the review work is to give an overview from the published reports on the evolution and benefits of the fast track process over time in oesophageal surgery.