Araştırma Makalesi
Evaluation of Pre-Operative and Post-Operative Practices of Patients Undergoing Abdominal Surgery According to ERAS Protocol
Öz
Purpose: This study was conducted to evaluate the pre-operative and post-operative practices of patients undergoing abdominal surgery, according to the Enhanced Recovery After Surgery protocol.
Material and Methods: The study was conducted in May-June 2022 as descriptive - cross-sectional. Patients who underwent abdominal surgery in the general surgery clinics of a university hospital in Istanbul constituted the population of the study. No sample was selected and 102 volunteer patients who met the inclusion criteria were included in the study.
Results: In the study, it was observed that although most of the pre-operative and post-operative practices of patients undergoing abdominal surgery had high compliance with ERAS protocols, practices such as pre-operative fasting time and post-operative first oral intake time were low, and patients undergoing open surgery were discharged in an average of 6 days, while patients undergoing minimally invasive surgery (laparoscopic) were discharged in an average of 3 days.
Conclusion: According to the results of the study, it was determined that all elements of ERAS protocols are still not complied with in the clinics. Regular auditing of compliance with the protocol and reporting of results in clinics is very important and it is recommended to support this research with larger-scale and multicenter studies.
Anahtar Kelimeler
Surgery surgical procedures enhaced recovery after surgery surgical nursing
Etik Beyan
Ethical approval was received from the Istanbul Unıversity Cerrahpaşa Social Sciences and Humanities Research Ethical Committee (Date: 10.05.2022, Decision No: 2022/156) and institutional approval (06.05.2022-375455) were obtained. Before starting the study, patients were asked about their willingness to participate in the study and informed consent was obtained from those who agreed.
Destekleyen Kurum
No
Teşekkür
We want to thank all the patients who volunteered to contribute to this study.
Kaynakça
- Bozkirli B, Gundogdu R, ERSOY P, Akbaba S, Temel H, Sayin T. Did the ERAS protocol affect our results in colorectal surgery? ERAS protokolü kolorektal cerrahi sonuçlarimizi etkiledi mi? Turk J Surg 2012;28(3):149-152.
- Ljungqvist O, Hubner M. Enhanced recovery after surgery—ERAS—principles, practice and feasibility in the elderly. Aging Clin Exp Res 2018 Mar;30(3):249–52.
- Tezber K, Aviles C, Eller M, Cochran A, Iannitti D, Vrochides D, et al. Implementing enhanced recovery after surgery (ERAS) program on a specialty nursing unit. JONA J Nurs Adm 2018;48(6):303–9.
- Cooper SL, Panesar P, Davidson J. Preoperative optimization and enhanced recovery after surgery. Surg Oxf 2022;40(12):790–5.
- Achrekar MS. Enhanced recovery after surgery (ERAS) nursing programme. Asia-Pac J Oncol Nurs 2022;9(7):100041.
- Brady KM, Keller DS, Delaney CP. Successful implementation of an enhanced recovery pathway: the nurse’s role. AORN J 2015;102(5):469–81.
- Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, et al. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS ®) Society Recommendations: 2018. World J Surg 2019;43(3):659–95.
- Pal AR, Mitra S, Aich S, Goswami J. Existing practice of perioperative management of colorectal surgeries in a regional cancer institute and compliance with ERAS guidelines. Indian J Anaesth 2019;63(1):26–30.
- Balfour A. Understanding the benefits and implications of Enhanced Recovery After Surgery. Nurs Stand 2019;34(7):70-75.
- Özkeçeci F, Yavan T. Elektif sezaryen ameliyatlarında yapılan perioperatif uygulamaların ERAS protokolüne göre değerlendirilmesi. Cukurova Med J 2020;45(4):1607–16.
- Yayla A, ESKİCİ V, Emrah AY, Nadiye Ö, Gülfidan K. Ameliyat Öncesi ve Sonrası Dönemde Yapılan Uygulamaların ERAS Protokolüne Uygunluğunun Değerlendirilmesi. İstanbul Gelişim Üniversitesi Sağlık Bilim Derg 2022;(18):734–50.
- Keller DS, Delaney CP, Senagore AJ, Feldman LS. Uptake of enhanced recovery practices by SAGES members: a survey. Surg Endosc 2017;31:3519–26.
- Leeds IL, Alimi Y, Hobson DR, Efron JE, Wick EC, Haut ER, et al. Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway. Dis Colon Rectum 2017;60(10):1092–101.
- Oodit R, Biccard BM, Panieri E, Alvarez AO, Sioson MRS, Maswime S, et al. Guidelines for Perioperative Care in Elective Abdominal and Pelvic Surgery at Primary and Secondary Hospitals in Low–Middle‐Income Countries (LMIC’s): Enhanced Recovery After Surgery (ERAS) Society Recommendation. World J Surg 2022;46(8):1826–43.
- Lassen K, Coolsen MM, Slim K, Carli F, de Aguilar-Nascimento JE, Schäfer M, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr. 2012;31(6):817–30.
- Thorell A, MacCormick AD, Awad S, Reynolds N, Roulin D, Demartines N, et al. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations. World J Surg 2016;40(9):2065–83.
- Arrick L, Mayson K, Hong T, Warnock G. Enhanced recovery after surgery in colorectal surgery: impact of protocol adherence on patient outcomes. J Clin Anesth 2019;55:7–12.
- Pędziwiatr M, Pisarska M, Wierdak M, Major P, Rubinkiewicz M, Kisielewski M, et al. The use of the enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic surgery for colorectal cancer–a comparative analysis of patients aged above 80 and below 55. Pol J Surg 2015;87(11):565–72.
- Ongün P, Ak ES. Assessment of knowledge levels of nurses working in surgical clinics about ERAS protocol. 2020 [cited 2024 Mar 25]; Available from: https://dspace.balikesir.edu.tr/xmlui/handle/20.500.12462/11176
- ERAS Türkiye Association. Basic elements of ERAS protocols [Internet]. 2022 [cited 2022 Apr 25]. Available from: https://eras.org.tr/page.php?id=10&saglikCalisani=true
- Özmen GÇ., Serpici A, Gürsoy A, & Çilingir D. Preoperatif dönemde hasta bakımına yönelik yenilikçi bir yaklaşım: ERAS’ı ne kadar uyguluyoruz?. Anatolian Journal of Health Research 2021;1(1):14-17.
- Gee E. The National VTE Exemplar Centres Network response to implementation of updated NICE guidance: venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism (NG89). Br J Haematol 2019;186(5):792–3.
- Nelson RL, Glenny AM, Song F. Antimicrobial prophylaxis for colorectal surgery. Sao Paulo Med J 2012;130:208–208.
- Bekmezci E, Meram HE. Jinekolojik Kanserlerde ERAS Protokolü Çerçevesinde Güncel Hemşirelik Yaklaşımı. J Nursology 2022;25(2):106–10.
- Regenbogen SE, Read TE, Roberts PL, Marcello PW, Schoetz DJ, Ricciardi R. Urinary tract infection after colon and rectal resections: more common than predicted by risk-adjustment models. J Am Coll Surg 2011;213(6):784–92.
- Ahmed MR, Ahmed WAS, Atwa KA, Metwally L. Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial. Eur J Obstet Gynecol Reprod Biol 2014;176:60–3.
- Gök F. Ameliyat öncesi aç kalma: Sistematik derleme. Pamukkale Medical Journal 2018;11(2):183–94.
- Tazreean R, Nelson G, Twomey R. Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements. J Comp Eff Res 2022;11(2):121–9.
- De Almeida EPM, De Almeida JP, Landoni G, Galas F, Fukushima JT, Fominskiy E, et al. Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial. BJA Br J Anaesth 2017;119(5):900–7.
- Alcántara-Moral M, Serra-Aracil X, Gil-Egea MJ, Frasson M, Flor-Lorente B, Garcia-Granero E, et al. Observational cross-sectional study of compliance with the fast track protocol in elective surgery for colon cancer in Spain. Int J Colorectal Dis 2014;29:477–83.
- Cakir H, Van Stijn MFM, Lopes Cardozo AMF, Langenhorst BLAM, Schreurs WH, Van Der Ploeg TJ, et al. Adherence to Enhanced Recovery After Surgery and length of stay after colonic resection. Colorectal Dis 2013;15(8):1019–25.
- Pędziwiatr M, Kisialeuski M, Wierdak M, Stanek M, Natkaniec M, Matłok M, et al. Early implementation of Enhanced Recovery After Surgery (ERAS®) protocol–compliance improves outcomes: a prospective cohort study. Int J Surg 2015;21:75–81.
- Meşe S, Köşgeroğlu N. Cerrahi Hastalara Özgü Taburculuk Eğitimi Memnuniyet Ölçeği’nin Geliştirilmesi. Turk Klin J Nurs Sci 2021;13(4):759-68.
- Philp S, Carter J, Barnett C, D’Abrew N, Pather S, White K. Patients’ perspectives of fast-track surgery and the role of the fast-track clinical nurse consultant in gynecological oncology. Holist Nurs Pract 2015;29(3):158–66.
- Asklid D, Ljungqvist O, Xu Y, Gustafsson UO. Short-term outcome in robotic vs laparoscopic and open rectal tumor surgery within an ERAS protocol: a retrospective cohort study from the Swedish ERAS database. Surg Endosc 2022;36(3):2006–17.
- Greco M, Capretti G, Beretta L, Gemma M, Pecorelli N, Braga M. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World J Surg 2014;38:1531–41.
- Kırık MS. Kolorektal ameliyatlarda klinik alanda ameliyat öncesi sırası ve sonrası uygulamaların ERAS protokolüne uygunluğunun karşılaştırılması [Master's thesis]. Gaziantep: Sanko Üniversitesi, Sağlık Bilimleri Enstitüsü; 2018.
- Çelebi Ş. Cerrahi kliniğinde yatan hastaların perioperatif uygulamalarının ERAS protokolüne uygunluğunun ve hasta sonuçlarına etkisinin değerlendirilmesi [Master's thesis]. Lisansüstü Eğitim Enstitüsü; 2019.
- Yıldırım Ç. Jinekolojik cerrahi geçiren kadınlarda yapılan uygulamaların ERAS protokolüne göre değerlendirilmesi [Master's thesis]. Sağlık Bilimleri Üniversitesi, Sağlık Bilimleri Enstitüsü; 2017.
Evaluation of Pre-Operative and Post-Operative Practices of Patients Undergoing Abdominal Surgery According to ERAS Protocol
Öz
Kaynakça
- Bozkirli B, Gundogdu R, ERSOY P, Akbaba S, Temel H, Sayin T. Did the ERAS protocol affect our results in colorectal surgery? ERAS protokolü kolorektal cerrahi sonuçlarimizi etkiledi mi? Turk J Surg 2012;28(3):149-152.
- Ljungqvist O, Hubner M. Enhanced recovery after surgery—ERAS—principles, practice and feasibility in the elderly. Aging Clin Exp Res 2018 Mar;30(3):249–52.
- Tezber K, Aviles C, Eller M, Cochran A, Iannitti D, Vrochides D, et al. Implementing enhanced recovery after surgery (ERAS) program on a specialty nursing unit. JONA J Nurs Adm 2018;48(6):303–9.
- Cooper SL, Panesar P, Davidson J. Preoperative optimization and enhanced recovery after surgery. Surg Oxf 2022;40(12):790–5.
- Achrekar MS. Enhanced recovery after surgery (ERAS) nursing programme. Asia-Pac J Oncol Nurs 2022;9(7):100041.
- Brady KM, Keller DS, Delaney CP. Successful implementation of an enhanced recovery pathway: the nurse’s role. AORN J 2015;102(5):469–81.
- Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, et al. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS ®) Society Recommendations: 2018. World J Surg 2019;43(3):659–95.
- Pal AR, Mitra S, Aich S, Goswami J. Existing practice of perioperative management of colorectal surgeries in a regional cancer institute and compliance with ERAS guidelines. Indian J Anaesth 2019;63(1):26–30.
- Balfour A. Understanding the benefits and implications of Enhanced Recovery After Surgery. Nurs Stand 2019;34(7):70-75.
- Özkeçeci F, Yavan T. Elektif sezaryen ameliyatlarında yapılan perioperatif uygulamaların ERAS protokolüne göre değerlendirilmesi. Cukurova Med J 2020;45(4):1607–16.
- Yayla A, ESKİCİ V, Emrah AY, Nadiye Ö, Gülfidan K. Ameliyat Öncesi ve Sonrası Dönemde Yapılan Uygulamaların ERAS Protokolüne Uygunluğunun Değerlendirilmesi. İstanbul Gelişim Üniversitesi Sağlık Bilim Derg 2022;(18):734–50.
- Keller DS, Delaney CP, Senagore AJ, Feldman LS. Uptake of enhanced recovery practices by SAGES members: a survey. Surg Endosc 2017;31:3519–26.
- Leeds IL, Alimi Y, Hobson DR, Efron JE, Wick EC, Haut ER, et al. Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway. Dis Colon Rectum 2017;60(10):1092–101.
- Oodit R, Biccard BM, Panieri E, Alvarez AO, Sioson MRS, Maswime S, et al. Guidelines for Perioperative Care in Elective Abdominal and Pelvic Surgery at Primary and Secondary Hospitals in Low–Middle‐Income Countries (LMIC’s): Enhanced Recovery After Surgery (ERAS) Society Recommendation. World J Surg 2022;46(8):1826–43.
- Lassen K, Coolsen MM, Slim K, Carli F, de Aguilar-Nascimento JE, Schäfer M, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr. 2012;31(6):817–30.
- Thorell A, MacCormick AD, Awad S, Reynolds N, Roulin D, Demartines N, et al. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations. World J Surg 2016;40(9):2065–83.
- Arrick L, Mayson K, Hong T, Warnock G. Enhanced recovery after surgery in colorectal surgery: impact of protocol adherence on patient outcomes. J Clin Anesth 2019;55:7–12.
- Pędziwiatr M, Pisarska M, Wierdak M, Major P, Rubinkiewicz M, Kisielewski M, et al. The use of the enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic surgery for colorectal cancer–a comparative analysis of patients aged above 80 and below 55. Pol J Surg 2015;87(11):565–72.
- Ongün P, Ak ES. Assessment of knowledge levels of nurses working in surgical clinics about ERAS protocol. 2020 [cited 2024 Mar 25]; Available from: https://dspace.balikesir.edu.tr/xmlui/handle/20.500.12462/11176
- ERAS Türkiye Association. Basic elements of ERAS protocols [Internet]. 2022 [cited 2022 Apr 25]. Available from: https://eras.org.tr/page.php?id=10&saglikCalisani=true
- Özmen GÇ., Serpici A, Gürsoy A, & Çilingir D. Preoperatif dönemde hasta bakımına yönelik yenilikçi bir yaklaşım: ERAS’ı ne kadar uyguluyoruz?. Anatolian Journal of Health Research 2021;1(1):14-17.
- Gee E. The National VTE Exemplar Centres Network response to implementation of updated NICE guidance: venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism (NG89). Br J Haematol 2019;186(5):792–3.
- Nelson RL, Glenny AM, Song F. Antimicrobial prophylaxis for colorectal surgery. Sao Paulo Med J 2012;130:208–208.
- Bekmezci E, Meram HE. Jinekolojik Kanserlerde ERAS Protokolü Çerçevesinde Güncel Hemşirelik Yaklaşımı. J Nursology 2022;25(2):106–10.
- Regenbogen SE, Read TE, Roberts PL, Marcello PW, Schoetz DJ, Ricciardi R. Urinary tract infection after colon and rectal resections: more common than predicted by risk-adjustment models. J Am Coll Surg 2011;213(6):784–92.
- Ahmed MR, Ahmed WAS, Atwa KA, Metwally L. Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial. Eur J Obstet Gynecol Reprod Biol 2014;176:60–3.
- Gök F. Ameliyat öncesi aç kalma: Sistematik derleme. Pamukkale Medical Journal 2018;11(2):183–94.
- Tazreean R, Nelson G, Twomey R. Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements. J Comp Eff Res 2022;11(2):121–9.
- De Almeida EPM, De Almeida JP, Landoni G, Galas F, Fukushima JT, Fominskiy E, et al. Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial. BJA Br J Anaesth 2017;119(5):900–7.
- Alcántara-Moral M, Serra-Aracil X, Gil-Egea MJ, Frasson M, Flor-Lorente B, Garcia-Granero E, et al. Observational cross-sectional study of compliance with the fast track protocol in elective surgery for colon cancer in Spain. Int J Colorectal Dis 2014;29:477–83.
- Cakir H, Van Stijn MFM, Lopes Cardozo AMF, Langenhorst BLAM, Schreurs WH, Van Der Ploeg TJ, et al. Adherence to Enhanced Recovery After Surgery and length of stay after colonic resection. Colorectal Dis 2013;15(8):1019–25.
- Pędziwiatr M, Kisialeuski M, Wierdak M, Stanek M, Natkaniec M, Matłok M, et al. Early implementation of Enhanced Recovery After Surgery (ERAS®) protocol–compliance improves outcomes: a prospective cohort study. Int J Surg 2015;21:75–81.
- Meşe S, Köşgeroğlu N. Cerrahi Hastalara Özgü Taburculuk Eğitimi Memnuniyet Ölçeği’nin Geliştirilmesi. Turk Klin J Nurs Sci 2021;13(4):759-68.
- Philp S, Carter J, Barnett C, D’Abrew N, Pather S, White K. Patients’ perspectives of fast-track surgery and the role of the fast-track clinical nurse consultant in gynecological oncology. Holist Nurs Pract 2015;29(3):158–66.
- Asklid D, Ljungqvist O, Xu Y, Gustafsson UO. Short-term outcome in robotic vs laparoscopic and open rectal tumor surgery within an ERAS protocol: a retrospective cohort study from the Swedish ERAS database. Surg Endosc 2022;36(3):2006–17.
- Greco M, Capretti G, Beretta L, Gemma M, Pecorelli N, Braga M. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World J Surg 2014;38:1531–41.
- Kırık MS. Kolorektal ameliyatlarda klinik alanda ameliyat öncesi sırası ve sonrası uygulamaların ERAS protokolüne uygunluğunun karşılaştırılması [Master's thesis]. Gaziantep: Sanko Üniversitesi, Sağlık Bilimleri Enstitüsü; 2018.
- Çelebi Ş. Cerrahi kliniğinde yatan hastaların perioperatif uygulamalarının ERAS protokolüne uygunluğunun ve hasta sonuçlarına etkisinin değerlendirilmesi [Master's thesis]. Lisansüstü Eğitim Enstitüsü; 2019.
- Yıldırım Ç. Jinekolojik cerrahi geçiren kadınlarda yapılan uygulamaların ERAS protokolüne göre değerlendirilmesi [Master's thesis]. Sağlık Bilimleri Üniversitesi, Sağlık Bilimleri Enstitüsü; 2017.
Toplam 39 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mayıs 2025 |
| Gönderilme Tarihi | 1 Mayıs 2024 |
| Kabul Tarihi | 11 Nisan 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 9 Sayı: 2 |
