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Background: The impact of the anesthesia management during cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of colorectal peritoneal carcinomatosis (CRPC) on postoperative outcomes might be of major importance in the process of postoperative recovery. It might have a significant impact on intra- and postoperative outcomes, but the evaluation of this impact seems to be under-reported. To investigate the question whether the anesthesia management was reported in previous studies done in this population and if it had any impact on postoperative outcomes, we propose to conduct a systematic review of the published literature. Methods: For this review, we will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). Medline/PubMed, Embase, EBM Reviews and the Cochrane Database of Systematic Reviews (CDSR) will be systematically consulted for eligible studies without age, gender, ethnic, and language restriction. The goal of this review will be to assess whether anesthesia monitoring, dosing, and analgesia protocols were reported in this literature on this specific procedure and whether the impact of the anesthesia management on intraoperative safety and postoperative recovery was evaluated. Results: The results of this systematic review will allow to answer the initial question: has the impact of anesthesia management on intraoperative safety and patients’ postoperative recovery already been studied and reported in the past for this type of major surgery? And does anesthesia have any impact on postoperative outcomes? Discussion: In the hypothesis that the impact of anesthesia management on patients’ postoperative recovery has never been studied, or very little reported in previous studies in this type of major surgery, it would be justified to conduct a randomized controlled trial on this specific objective. Registration: This systematic review protocol was registered in PROSPERO, under the registration number CRD42019124162.

Contexte : Le remplacement articulaire de la hanche (PTH) et du genou (PTG) en court séjour (, Context Total hip replacement (THR) and total knee replacement (TKR) in a fast track surgery setting (less than 24 h) are becoming a new trend in orthopedics. However, the reduced length of stay should not affect the safety and efficiency of the surgical procedure. The aim of this study is to evaluate the implementation of a fast track surgery program. We hypothesized that the THR and TKR fast track protocol would present a similar or inferior complication rate compared to the standard procedure without increasing the cost of care. Method: We compared an experimental group of 120 patients hospitalized less than 24 hours (21TKR, 93 THR) to a retrospective control group (by medical file revue) of 150 patients hospitalized more than 24 hours (35 TKR, 115 THR). Undesirable events (up to one year after the procedure following the Clavien-Dindo scale), pain, surgical data, length of stay and quality of life (HOOS, KOOS, SF-36) were compared between groups. The failures to discharge in less than 24 hours were listed and a comparison of hospitalisation cost was described. Results: Six patients from the experimental group abandoned before their surgery. Among the experimental group, 7 patients failed to discharge in less than 24 hours. The length of stay significantly decreased of 2,8 days for the THR and 3,9 days for the TKR for the experimental group (THR 0,1 versus 2,9 and 4,9 versus 1,0 for the TKR p0,001). We demonstrated a statistically significant decrease rate of complication graded 1 or 2 per patient in the experimental group (0,76vs 3,00 p0,001). No significant differences were found for higher grade the complications. The estimation of cost reduction brought by the fast track protocol were 1489,34$ per subject for THR and 4206,45$ for TKR. Conclusion: The fast track hip and knee surgery program implantation has permitted a reduction in the length of stay while reducing the rate of postoperative undesirable events and a reduction in costs. The program implementation to a larger group of patients could improve the quality of care and promote substantial economic savings.