Enhanced recovery protocols in patients undergoing pancreatic surgery: An umbrella review

Li, Jing; Lin, Frances; Yu, Shuiliang; Marshall, Andrea P.

doi:10.1002/nop2.923

Cited by 3 publications

(2 citation statements)

References 55 publications

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“…Our results confirmed these findings and showed that patients undergoing pancreatic surgery do indeed consider hospitals as an unwelcoming space for mobilisation and early recovery. Early removal of drains, as one component of ERAS, is important to promote optimal postoperative recovery 46. Hence, health professionals may remove unnecessary drains early according to the patients’ clinical condition.…”

Section: Discussionmentioning

confidence: 99%

“…Early removal of drains, as one component of ERAS, is important to promote optimal postoperative recovery. 46 Hence, health professionals may remove unnecessary drains early according to the patients’ clinical condition. It is not surprising that a lack of staffing is a barrier to patients’ successful participation in mobilisation, and this barrier is not easily changeable.…”

Section: Discussionmentioning

confidence: 99%

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Factors influencing early mobilisation for patients undergoing pancreatic surgery from multiple perspectives: a qualitative descriptive study

Ni,

Li,

Zhou

et al. 2023

BMJ Open

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ObjectivesDespite early mobilisation as a key component of enhanced recovery after surgery pathways for pancreatic surgery, the implementation of early mobilisation remains unsatisfactory. What factors influence the implementation of early mobilisation from the lens of all stakeholders is unclear. The aim of this study was to identify the influencing factors of early mobilisation in pancreatic surgery from the perspective of patients, family members and health professionals.DesignA qualitative descriptive design using individual interviews and focus groups.Setting and participantsTwenty-two patients undergoing pancreatic surgery, 10 family members and 10 healthcare professionals from a large university teaching hospital in China.MethodsWe collected data on participants’ views on factors influencing early mobilisation after pancreatic surgery. Two researchers independently reviewed the transcripts and emergent coding. The data were analysed using qualitative content analysis.ResultsThree main categories that influenced the implementation of early mobilisation in pancreatic surgery were identified: (1) attitude towards early postoperative mobilisation (eg, perceived advantages or disadvantages of early mobilisation), (2) subjective norm (eg, impact from health professionals, family members and fellow patients) and (3) perceived behavioural control (eg, knowledge, abilities, resources and environment).ConclusionFactors influencing early mobilisation are diverse and multidimensional. The successful implementation of early mobilisation requires the dedication of both patients and healthcare professionals.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors influencing early mobilisation for patients undergoing pancreatic surgery from multiple perspectives: a qualitative descriptive study

Ni,

Li,

Zhou

et al. 2023

BMJ Open

View full text Add to dashboard Cite

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Enhanced recovery protocols in patients undergoing pancreatic surgery: An umbrella review

Lin

et al. 2021

Nursing Open

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Analysis of enhanced recovery protocol failure for pancreatic surgery

Дроздов

Короткевич²,

Klokov

et al. 2023

VECS

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Introduction. Enhanced recovery protocols (ERP) after surgery are evidence-based perioperative management programs aimed at reducing the response to surgical stress and accelerating recovery. These protocols have shown their effectiveness in various surgical sections, including surgical pancreatology. However, in some patients who have undergone pancreatic surgery, these protocols are not effective. The aim of the study was to analyse risk factors for ERP failure during pancreatic surgery, and to develop a predictive model for assessing the risk of ERP failure. Material and methods. A retrospective - prospective two-center study included 122 patients who underwent surgical interventions on the pancreas. ERP was considered unsuccessful if one or more of the following signs were found in a patient: the duration of postoperative hospitalization exceeding 14 days, in-hospital or 30-day mortality, readmission within 30 days. Patients included in the study were divided into two groups: 1) patients who did not have signs of ERP failure - the enhanced recovery group (ER), 2) patients who had signs of ERP failure (non-ER group). The authors evaluated clinical factors that might be associated with the risk of ERP failure. Results. The non-ER group included 46 patients. Univariate and multivariate logistic analysis allowed specifying independent risk factors for ERP failure: age over 70 years (p=0.01), presence of sarcopenia (odds ratio (OR) 4.75, 95% confidence interval (95% CI) 1.7 - 11.9, p=0.01), ASA III score (OR 1.8, 95% CI 1.1 - 2.6, p=0.04), density of the pancreas parenchyma (OR 5.9, 95 % CI 1.8 15.4, p0.01). To develop a score for the risk of ERP failure, each feature was empirically assigned points from 1 to 3 taking into account its severity (the odds ratio value). With a score of 4, the risk of ERP failure was assessed as high, with a score 4, the risk of ERP failure was assessed as low. The sensitivity, specificity and overall accuracy of the developed model were 84.8%, 82.9% and 83.6%, respectively. Conclusions. Based on the study results, the authors developed a scoring prognostic model to evaluate the risk of ERP failure in patients exposed to pancreatic surgery. This model can be used to stratify patients according to their risk of ERP failure (high or low

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Enhanced recovery protocols in patients undergoing pancreatic surgery: An umbrella review

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 3 publications

References 55 publications

Factors influencing early mobilisation for patients undergoing pancreatic surgery from multiple perspectives: a qualitative descriptive study

Factors influencing early mobilisation for patients undergoing pancreatic surgery from multiple perspectives: a qualitative descriptive study

Enhanced recovery protocols in patients undergoing pancreatic surgery: An umbrella review

Analysis of enhanced recovery protocol failure for pancreatic surgery

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