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Table 1 Checklist of fast track and traditional management

From: Fast-track surgery after gynaecological oncological surgery: study protocol for a prospective randomised controlled trial

Allocation

FTS management

Traditional management

Computer-generated random numbers

Computer-generated random numbers

Pre-operative

 

Pre-operative assessment, counselling and FT management education

No FT management education

Information on the fast-track treatment and informed consent

Information on traditional treatment and informed consent

Pre-operative nutritional drink up to 4 h prior to surgery (TPF-D produced by FreseniusKabi Deutschland GmbH, Bad Homburg, Germany). Fasting - solid food 6 h before and liquid food intake of clear fluids 2 h before anaesthesia

Pre-operative fasting at least 8 h

Patients do not receive mechanical bowel preparation, only oral intestinal cleaner 12 h pre-operation can be accepted, but no need of liquid stool

Oral bowel preparation or mechanical bowel preparation until liquid stool

Anti-microbial prophylaxis and skin preparation

Anti-microbial prophylaxis and skin preparation

Pre-operative treatment with carbohydrates (10% glucose 400 ml orally 2–3 h before operation) (patients without diabetes)

No oral intake on the operation day

Intra-operative

 

Avoiding hypothermia, keeping the intra-operative core temperature at 36 ± 0.5 °C

Keeping the intra-operative core temperature at 34.7 ± 0.6 °C

Anti-emetics at end of anaesthesia

Not every patient gets anti-emetics at end of anaesthesia

Post-operative

 

Post-operative glycaemic control

Post-operative glycaemic control only with diabetes

Preventive post-operative nausea and vomiting (PONV) control

Post-operative nausea and vomiting (PONV) control when it happens

Early post-operative diet (3–6 h after surgery, patients resume a liquid diet, 12 h after surgery patients begin to take solid diet)

6 h after surgery, patients resume a liquid diet, patients begin to take solid diet after anal exhaust

Early mobilisation

Early mobilisation

Time to drain removal less than 24 h (eliminate post-operative bleeding and urinary fistula, intestinal fistula)

Time to drain removal less than 48 h (eliminate post-operative bleeding and urinary fistula, intestinal fistula)

Audit

Systematic audit improves compliance and clinical outcomes