Fast-track programs

The widespread of minimally invasive liver surgery has not only contributed to the evolution of the surgical technique but also innovation of patient management. Indeed, the application of multimodal perioperative care protocols, commonly referred as fast-track or enhanced recovery programs (enhanced recovery after surgery, ERAS), has achieved significant improvements in the outcome of a variety of surgical procedures. Targeting factors that delay postoperative recovery (pain, gut dysfunction, and immobility) and combining a series of interventions to reduce perioperative stress and organ dysfunction, such programs have shown to accelerate postoperative recovery and reduce length of stay, without affecting rate of postoperative complications or even reducing them. A structured and detailed program with well-defined recovery and discharge criteria has been developed and is currently introduced into clinical practice of centers involved in this program. Patients with benign tumors may benefit from these programs in terms of quality of life, cosmetic results, and social costs.