Authors: Walter, Catherine Jane; Smith, Adrian; Guillou, Pierre

Source: Annals of The Royal College of Surgeons of England, Volume 88, Number 2, March 2006 , pp. 191-195(5)

Publisher: The Royal College of Surgeons of England

Abstract:

INTRODUCTION: Fast-track surgery is a novel approach which uses a multimodal package of changes to traditional surgical care to reduce the stress response evoked by surgery allowing for enhanced recovery times. The depth of understanding and application of fast-track principles to general surgical practice by consultant surgeons is unknown.

MATERIALS AND METHODS: 'Core management features' central to published fast-track general surgical studies were identified following a comprehensive Medline literature search. The knowledge and application of these features were examined in a postal questionnaire sent to 116 general surgeons in a single region.

RESULTS: Of respondents, 31% indicated they were currently using fast-track surgery (the 'fast-trackers'). The number of fast-track compliant responses was calculated for each consultant (range, 1-12 of 14). Mean scores for 'fast-trackers' of 8.45 (± 2.188) and 'non-fast-trackers' of 6.16 (± 2.352) showed no significant differences (P > 0.6). The 'fast-trackers' median estimated length of stay (LOS) was 5 days (inter-quartile range [IQR], 4-7) which was significantly lower than the 7 day (IQR 6-8) LOS estimates given by the 'non-fast-trackers' (P < 0.01).

CONCLUSIONS: Despite estimating reduced LOS, no significant difference in total fast-track compliant responses was found between the 'fast-tracker' and 'non-fast-tracker' groups. The 'fast-trackers' estimated LOS of 5 days is 2.5 times the 2 day LOS reported in the published fast-track studies. A significant gap exists between the perception and realisation of fast-track methodology amongst general surgeons.

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Keywords: FAST-TRACK; GENERAL SURGERY; LENGTH OF STAY; QUESTIONNAIRE

Document Type: Research article

DOI: http://dx.doi.org/10.1308/003588406X94940

Affiliations: 1: Academic Surgical Unit, St James's University Hospital, Leeds, UK

Publication date: 2006-03-01

More about this publication?

• The Annals of The Royal College of Surgeons of England is the official journal of the College and is published eight times a year in January, March, April, May, July, September, October and November. The main aim of the journal is to publish high quality, peer-reviewed papers that relate to all branches of surgery.
  
  The Annals also includes letters and comments, a regular technical section, NICE news, controversial topics, CORESS feedback, book reviews and the best trainee presentations from England and Wales. The editorial board is composed of members of the College Council and experts from across the surgical specialties.
  
  Archive issues of the Annals of The Royal College of Surgeons of England are available via the PubMed Central database
  
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