Scientific article
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Fast-Track in Minimally Invasive Gynecology: A Randomized Trial Comparing Costs and Clinical Outcomes

Published inFrontiers in surgery, vol. 8, 773653
Publication date2021
First online date2021-11-11

Study Objective: Evaluate the effects of a fast-track (FT) protocol on costs and post-operative recovery.

Methods: One hundred and seventy women undergoing total laparoscopic hysterectomy for a benign indication were randomized in a FT protocol or a usual care protocol. A FT protocol included the combination of minimally invasive surgery, analgesia optimization, early oral refeeding and rapid mobilization of patients was compared to a usual care protocol. Primary outcome was costs. Secondary outcomes were length of stay, post-operative morbidity and patient satisfaction.

Main Results: The mean total cost in the FT group was 13,070 ± 4,321 Euros (EUR) per patient, and that in the usual care group was 3.5% higher at 13,527 ± 3,925 EUR (p= 0.49). The FT group had lower inpatient surgical costs but higher total ambulatory costs during the first post-operative month. The mean hospital stay in the FT group was 52.7 ± 26.8 h, and that in the usual care group was 20% higher at 65.8 ± 33.7 h (p= 0.006). Morbidity during the first post-operative month was not significantly different between the two groups. On their day of discharge, the proportion of patients satisfied with pain management was similar in both groups [83% in FT and 78% in the usual care group (p= 0.57)]. Satisfaction with medical follow-up 1 month after surgery was also similar [91% in FT and 88% in the usual care group (p= 0.69)].

Conclusion: Implementation of a FT protocol in laparoscopic hysterectomy for benign indications has minimal non-significant effects on costs but significantly reduces hospital stay without increasing post-operative morbidity nor decreasing patient satisfaction.

Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04839263.

  • Fast-track
  • Hospital costs
  • Hospital stay
  • Laparoscopic hysterectomy (LH)
  • Pain assessment
  • Post-operative morbidity
Citation (ISO format)
LAMBAT, Shahzia et al. Fast-Track in Minimally Invasive Gynecology: A Randomized Trial Comparing Costs and Clinical Outcomes. In: Frontiers in surgery, 2021, vol. 8, p. 773653. doi: 10.3389/fsurg.2021.773653
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Article (Published version)
ISSN of the journal2296-875X

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Creation09/05/2022 7:06:53 AM
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Update time05/12/2023 3:34:45 PM
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