Jinekolojik Cerrahide Ameliyat Sonrası Erken İyileşme: Sistematik Derleme

Year 2022, Volume: 7 Issue: 2, 331 - 338, 31.05.2022

Eda Polat , Merve Tuncer , Özlem İbrahimoğlu

Abstract

Ameliyat sonrası iyileşme protokolü (ERAS), erken iyileşmeyi hızlandırmayı ve ameliyat sonrası hasta sonuçlarını iyileştirmeyi amaçlar. Postoperatif komplikasyonların azaltılması ve önlenmesi, erken mobilizasyon, bulantı ve kusmanın multimodal yönetimi gibi bileşenleri içeren bu protokol, jinekolojik cerrahi geçiren hastalarda kullanıldığında cerrahi süreçleri olumlu etkiler. Bu çalışmanın amacı, jinekolojik cerrahi geçiren hastalarda ERAS protokollerinin kullanımını inceleme açısından güncel ve ilgili literatürü kullanmaktı. Bu nedenle, jinekolojik cerrahi geçiren hastalarda kullanılan ERAS protokollerini inceleyen makaleleri belirlemek için sistematik bir inceleme yapıldı. Ocak 2015 ile Ocak 2021 arasında PubMed, Science Direct, MEDLINE ve Google Scholar'da elektronik aramalar gerçekleştirildi. Birincil sonuç hastanede kalış süresiydi. İkincil sonuçlar erken iyileşme, postoperatif komplikasyonlar, ağrı yönetimi ve narkotik ilaçların kullanımını içermekteydi. Sistematik derlemeye 12 çalışma dahil edildi. Dahil edilen çalışmaların çoğu randomize kontrollü çalışmaydı. Çalışmaların altısı hızlandırılmış bakım protokollerinin tüm bileşenlerini kullanırken, diğerleri postoperatif analjezi, postoperatif bulantı ve kusma, erken mobilizasyon, sıvı ve karbonhidrat yükleme bileşenleri kullanmaktaydı. Çalışmaların sonuçları incelendiğinde bu protokollerin jinekolojik cerrahi sonrası hastanede kalış süresini kısalttığı, erken iyileşme ve erken mobilizasyon sağladığı, bulantı ve kusmayı azalttığı ve uygun ağrı yönetimini sağlayarak narkotik kullanımını azalttığı belirlendi. Jinekolojik cerrahi geçiren hastaların tedavi ve bakımlarında daha iyi sonuçlar elde edebilmek için bu hasta grubunda ERAS protokollerinin kullanılması gerekmektedir.

Keywords

Ameliyat sonrası erken iyileşme, jinekoloji, jinekolojik cerrahi, sistematik derleme

Supporting Institution

yoktur

Project Number

yoktur

Enhanced Recovery After Surgery (ERAS) in Gynecologic Surgery: A Systematic Review

Abstract

Enhanced recovery after surgery (ERAS) protocol aims to accelerate early recovery and improves postoperative patient outcomes. This protocol, which includes components such as reduction and prevention of postoperative complications, early mobilization, multimodal management of nausea and vomiting, positively affects surgical processes when used in patients undergoing gynaecological surgery. The aim of the present study was to use recent and relevant literature for examining the use of ERAS protocols in patients undergoing gynaecological surgery. Therefore, a systematic review was conducted to identify articles examining ERAS protocols used in patients who underwent gynaecological surgery. Electronic searches were performed in PubMed, Science Direct, MEDLINE, and Google Scholar between January 2015 and January 2021. The primary outcome was length of hospital stay. Secondary outcomes included early recovery, postoperative complications, pain management and narcotic drugs use. Twelve studies were included in the systematic review. Most of the included studies were randomize controlled trials. While six of the studies use all components of fast-track surgery protocols, others used postoperative analgesia, postoperative nausea and vomiting, early mobilization, fluid and carbohydrate loading components. When the results of the studies were examined, it was determined that these protocols shortened the length of hospital stay, provided early recovery and early mobilization, reduced nausea and vomiting, and decreased narcotic drugs use by providing appropriate pain management following gynaecological surgery. ERAS protocols need to be used in this patient group in order to achieve better results in the treatment and in the care of patients who have undergone gynaecological surgery.

Keywords

Enhanced recovery after surgery, Fast-track surgery, Gynecological surgery, Systematic review., Gynecology

Project Number

yoktur

References

• Jensen BT. Organization factors in the ERAS bladder cancer pathway: The multifarious role of the Eras nurse, why and what is important?. Semin Oncol Nurs. 2021;37(1):1-6.
• Seow-En I, Wu J, Yang LWY, Tan JSQ, Seah AWH, Foo FJ, et al. Results of a colorectal enhanced recovery after surgery (ERAS) programme and a qualitative analysis of healthcare workers’ perspectives. Asian J Surg. 2021;44:307-12.
• Ferrari F, Forte S, Sbalzer N, Zizioli V, Mauri M, Maggi C, et al. Validation of an enhanced recovery after surgery protocol in gynecologic surgery: An Italian randomized study. Am J Obstet Gynecol. 2020;223:543.e1-14.
• Nikodemski T, Biskup A, Taszarek A, Albin M, Chudecka-Głaz A, Cymbaluk-Płoska A, et al. Implementation of an enhanced recovery after surgery (ERAS) protocol in a gynaecology department – the follow-up at 1 year. Contemp Oncol. 2017;21:240-43.
• Hirji SA, Salenger R, Boyle EM, Williams J, Reddy VS, Grant MC, et al. Expert consensus of data elements for collection for enhanced recovery after cardiac surgery. World J Surg. 2021;45(4):917-25.
• Hübner M, Kusamura S, Villeneuve L, Al-Niaimi A, Alyami M, Balonov K, et al. Guidelines for perioperative care in cytoreductive surgery (crs) with or without hyperthermic intraperitoneal chemotherapy (hipec): Enhanced recovery after surgery (ERAS) society recommendations d part ii: postoperative management and special considerations. Eur J Surg Oncol. 2020;46(12):2292-310.
• Bogani G, Sarpietro G, Ferrandina G, Gallotta V, DI Donato V, Ditto A, et al. Enhanced recovery after surgery (ERAS) in gynecology oncology. Eur J Surg Oncol. 2021;47(5):952-9.
• Cherot E. ERAS: Improved outcomes post-cesarean. Contemporary OB/GYN. 2018;64(7):21–2.
• Bowden SJ, Dooley W, Hanrahan J, Kanu C, Halder S, Cormack C, et al. Fast-track pathway for elective caesarean section: a quality improvement initiative to promote day 1 discharge. BMJ Open Qual. 2019;8(2):e000465.
• Miralpeix E, Nick AM, Meyer LA, Cata J, Lasala J, Mena GE, et al. A call for new standard of care in perioperative gynecologic oncology practice: Impact of enhanced recovery after surgery (Eras) programs. Gynecol Oncol. 2016;141(2):371-8.
• Ahrq.org [Internet]. Healthcare Research and Quality Agency. Making Health Care Safer: A Critical Analysis of Patient Safety Practices; 2011 [cited 2021 Jan 27]. Available from: https://archive.ahrq.gov/clinic/ ptsafety/index.html
• Dickson EL, Stockwell E, Geller MA, Vogel RI, Mullany SA, Ghebre R, et al. Enhanced recovery program and length of stay after laparotomy on a gynecologic oncology service: A randomized controlled trial. Obstet Gynecol. 2017;129(2):355-62.
• Yilmaz G, Akca A, Aydin N. Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies. Ginekologia Polska. 2018;89(7):351-6.
• Ismail EA, Abo Elfadl GM, Bahloul M. Comparison of intraperitoneal versus intravenous dexamethasone on postoperative nausea and vomiting after gynecological laparoscopy: A randomized clinical trial. Korean J Anesthesiol. 2019;72(1):47-52.
• Ma K, Wu X, Chen Y, Yuan H. Effect of multimodal intervention on postoperative nausea and vomiting in patients undergoing gynecological laparoscopy. J Int Med Res. 2019;47(5):2026-33.
• Marquini GV, da Silva Pinheiro FE, da Costa Vieira AU, da Costa Pinto RM, Kuster Uyeda MGB, Girão MJBC, et al. Preoperative fasting abbreviation (Enhanced recovery after surgery protocol) and effects on the metabolism of patients undergoing gynecological surgeries under spinal anaesthesia: A randomized clinical trial. Nutrition. 2020;77:1-7.
• Wijk L, Franzen K, Ljungqvist O, Nilsson K. Enhanced recovery after surgery protocol in abdominal hysterectomies for malignant versus benign disease. Gynecol Obstet Invest. 2016;81:461-7.
• Modesitt SC, Sarosiek BM, Trowbridge ER, Redick DL, Shah PM, Thiele RH, et al. Enhanced recovery implementation in major gynecologic surgeries. Obstet Gynecol. 2016;128:457–66.
• Kuster Uyeda MGB, Batista Castello Girão MJ, Carbone ÉDSM, Machado Fonseca MC, Takaki MR, Ferreira Sartori MG. Fast-track protocol for perioperative care in gynecological surgery: Cross-sectional study. Taiwan J Obstet Gynecol. 2019;58:359-63.
• Chapman JS, Roddy E, Ueda S, Brooks R, Chen LL, Chen LM. Enhanced recovery pathways for improving outcomes after minimally invasive gynecologic oncology surgery. Obstet & Gynecol. 2016;128(1):138-44.
• Boitano TKL, Smith HJ, Rushton T, Johnston MC, Lawson P, Leath CA 3rd, et al. Impact of enhanced recovery after surgery (ERAS) protocol on gastrointestinal function in gynecologic oncology patients undergoing laparotomy. Gynecol Oncol. 2018;151:282-6.
• Carter-Brooks CM, Du AL, Ruppert KM, Romanova AL, Zyczynski HM. Implementation of an urogynecology-specific enhanced recovery after surgery (Eras) pathway. Am J Obstet Gynecol. 2018;219(5):495- 515.
• Kay AH, Venn M, Urban R, Gray HJ, Goff B. Postoperative narcotic use in patients with ovarian cancer on an enhanced recovery after surgery (ERAS) pathway. Gynecol Oncol. 2020;156:624-8.
• Prokopowicz A, Korzeniewska A, Byrka K. Patient anxiety of verticalization on day 0 after a cesarean section. Arch Gynecol Obstet. 2021;303:391-9.
• Lee K, Lee D, Huang M, Hunt E, Hedderson M. Enhanced recovery after surgery implementation in a cesarean section population in an integrated healthcare system. Obstet Gynecol. 2018;131:29S.
• Cua S, Humeidan M, Beal EW, Brethauer S, Pervo V, Papio J, et al. The effect of an enhanced recovery protocol on colorectal surgery patients with diabetes. J Surg Res. 2021;257:153-60.
• Carter J. Fast-track surgery in gynaecology and gynaecologic oncology: A review of a rolling clinical audit. ISRN Surg. 2012;2012:1- 19.
• Kalogera E, Dowdy SC. Enhanced recovery pathway in gynecologic surgery: Improving outcomes through evidence-based medicine. Obstet Gynecol Clin North Am. 2016;43(3):551-73.
• Relph S, Bell A, Sivashanmugarajan V, Munro K, Chigwidden K, Lloyd S, et al. Cost effectiveness of enhanced recovery after surgery programme for vaginal hysterectomy: A comparison of pre- and post-implementation expenditures. Int J Health Plann Manage. 2014;29(4):399–406.
• Carter J, Szabo R, Sim WW, Pather S, Philp S, Nattress K, et al. Fast track surgery: A clinical audit. Aust N Z J Obstet Gynaecol. 2010;50(2):159–63.
• Grant MC, Isada T, Ruzankin P, Whitman G, Lawton JS, Dodd-O J, et al. Results from an enhanced recovery program for cardiac surgery. J Thorac Cardiovasc Surg. 2020;159(4):1393–402.
• Sinclair DR, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted. Anesthesiology. 1999;91:109–18.
• Barclay KL, Zhu YY, Tacey MA. Nausea, vomiting and return of bowel function after colorectal surgery. ANZ J Surg. 2015;85:823-8.
• Medbery RL, Fernandez FG, Khullar OV. ERAS and patient reported outcomes in thoracic surgery: A review of current data. J Thorac Dis. 2019;11:976–86.
• Varadhan KK, Lobo DN. A meta-analysis of randomised controlled trials of intravenous fluid therapy in major elective open abdominal surgery: Getting the balance right. Proc Nutr Soc. 2010;69(4):488–98.
• Scott MJ, Baldini G, Fearon KC, Feldheiser A, Feldman LS, Gan TJ, et al. Enhanced recovery after surgery (ERAS) for gastrointestinal surgery, part 1: Pathophysiological considerations. Acta Anaesthesiol Scand. 2015;59(10):1212–31.
• Meyer LA, Lasala J, Iniesta MD, Nick AM, Munsell MF, Shi Q, et al. Effect of an enhanced recovery after surgery program on opioid use and patient-reported outcomes. Obstet Gynecol. 2018;132(2):281–90.
• de Aguilar-Nascimento JE, Caporossi C, Metelo JS, Tanajura GH, Canevari-de-Oliveira M, da Cunha Costa R. Safe intake of an oral supplement containing carbohydrates and whey protein shortly before sedation to gastroscopy; A double blind, randomized trial. Nutr Hosp. 2014;29:681–6.
• Breuer JP, von Dossow V, von Heymann C, Griesbach M, von Schickfus M, Mackh E, et al. Preoperative oral carbohydrate administration to ASA III-IV patients undergoing elective cardiac surgery. Anesth Analg. 2006;1035:1099–108.