The impact of Fast Track Surgery technology on the outcomes of laparoscopic non-hysterectomy interventions

Minimally invasive laparoscopic surgery and Fast Track Surgery (FTS) program for patients have had a significant impact on perioperative management and have practically replaced the practice of traditional management. This raises the question of whether long-term inpatient treatment is required.

Objective: To evaluate the protective effect of FTS technology in laparoscopic non-hysterectomy interventions in elective patients.

Materials and methods: This prospective cohort study included gynecological patients who underwent elective laparoscopic organ-preserving surgery for benign neoplasms (uterine fibroids, benign ovarian neoplasms, endometriosis, and chronic salpingitis). The study included 312 operated patients: 247 – in the Fast Track Surgery program (FTS, main group) and 65 – in traditional care (TC, control group). Data for the study were obtained from the electronic databases of the full-cycle medical information systems "Ariadna" and "Medialog" for the years 2021–2023. The primary criteria for evaluating the effectiveness of FTS technology were complications in the early postoperative period and time of patient discharge. Additionally, the dynamics of some laboratory parameters in the study groups were analyzed.

Results: The use of FTS technology led to a decrease in the length of hospital stay (RR=0.06, 95% CI: 0.03–0.11), frequency of nausea and vomiting in the postoperative period (RR=0.04, 95% CI: 0.002–0.69), and surgical site infections (RR=0.05, 95% CI: 0.002–1.00).

Conclusion: The use of FTS program in combination with minimally invasive laparoscopic gynecologic surgery for elective patients who underwent surgery for benign neoplasms of the uterus and appendages significantly reduced the incidence of postoperative complications and the duration of inpatient treatment, without increasing the frequency of rehospitalization.