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Perioperative enhanced recovery programmes for gynaecological cancer patients

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Abstract

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Background

Gynaecological malignancies contribute to 10% to 15% of cancers in women internationally. In recent years, a trend towards new perioperative care strategies has been documented as 'Fast Track (FT) surgery', or 'Enhanced Recovery Programmes' to replace some traditional approaches in surgical care. The FT multimodal programmes may enhance the postoperative recovery by means of reducing surgical stress. This systematic review aims to assess fully the beneficial and harmful effects of FT programmes in gynaecological cancer care.

Objectives

To evaluate the beneficial and harmful effects of FT programmes in gynaecological cancer care.

Search methods

We searched the following databases, The Cochrane Gynaecological Cancer Review Group's Trial Register, the Cochrane Central Register of Controlled Trials (CENTRAL) Issue 4, 2009, MEDLINE and EMBASE to November 2009. In addition, all reference lists of included trials were searched and experts in the gynaecological oncology community were contacted in an attempt to locate trials. This search was updated and re‐run to 1 May 2012, for this update.

Selection criteria

All randomised controlled trials (RCTs) comparing any type of FT programmes for surgery in gynaecological cancer to conventional recovery strategies were included.

Data collection and analysis

Two review authors independently screened studies for inclusion. Since no RCTs were identified, data collection and analysis could not be performed.

Main results

No studies were identified that met the inclusion criteria.

Authors' conclusions

We currently have no evidence from high‐quality studies to support or refute the use of perioperative enhanced recovery programmes for gynaecological cancer patients. Further well‐designed RCTs with standard FT programmes are needed. This review has been updated in 2012. The results of the original review published in 2010 remain unchanged.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

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Perioperative enhanced recovery programmes for women with gynaecological cancer

Gynaecological cancers lead to a significant amount of morbidity and mortality internationally. In recent years, a trend towards new perioperative care strategies has been documented. These 'Fast Track (FT) surgery' or 'Enhanced Recovery Programmes' replace traditional approaches in surgical care management. The FT multimodal programmes may enhance the postoperative recovery period by reducing surgical stress. The review authors found no high‐quality studies to support or refute the use of perioperative enhanced recovery programmes for gynaecological cancer patients.