Evaluation of the Impact of Preoperative Education in Ambulatory Laparoscopic Cholecystectomy. A Prospective, Double-Blind Randomized Trial

Magdaleno, Helena Subirana; Caro, Aleidis; Casas, Carles Olona; Padillo, Alba Díaz; Chacón, Mario Franco; Bargalló, Jordi Vadillo; Serra, Judit Saludes; Martín, Rosa Jorba

doi:10.1016/j.cireng.2017.10.011

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…The characteristics of the included studies by type of intervention, aggregate data from the included studies by type of intervention, RoB assessment, summary of findings, excluded studies, studies that fit the inclusion criteria but had no usable data, and relevant protocols of ongoing or unpublished studies are shown in the online supplemental digital content. We identified eight types of interventions administered in the preoperative period: nutritional (51 studies),30–80 respiratory (30 interventions of 29 studies)81–109 exercise (27 studies),110–136 multimodal (25 studies),100 108 137–159 educational (17 studies),160–176 psychological (16 studies),177–192 smoking and alcohol cessation (7 studies)193–199 and pharmacological (5 studies)200–204 (table 1).…”

Section: Resultsmentioning

confidence: 99%

Pre-admission interventions (prehabilitation) to improve outcome after major elective surgery: a systematic review and meta-analysis

et al. 2021

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ObjectiveTo determine the benefits and harms of pre-admission interventions (prehabilitation) on postoperative outcomes in patients undergoing major elective surgery.DesignSystematic review and meta-analysis of randomised controlled trials (RCTs) (published or unpublished). We searched Medline, Embase, CENTRAL, DARE, HTA and NHS EED, The Cochrane Library, CINAHL, PsychINFO and ISI Web of Science (June 2020).SettingSecondary care.ParticipantsPatients (≥18 years) undergoing major elective surgery (curative or palliative).InterventionsAny intervention administered in the preoperative period with the aim of improving postoperative outcomes.Outcomes and measuresPrimary outcomes were 30-day mortality, hospital length of stay (LoS) and postoperative complications. Secondary outcomes included LoS in intensive care unit or high dependency unit, perioperative morbidity, hospital readmission, postoperative pain, heath-related quality of life, outcomes specific to the intervention, intervention-specific adverse events and resource use.Review methodsTwo authors independently extracted data from eligible RCTs and assessed risk of bias and the certainty of evidence using Grading of Recommendations, Assessment, Development and Evaluation. Random-effects meta-analyses were used to pool data across trials.Results178 RCTs including eight types of intervention were included. Inspiratory muscle training (IMT), immunonutrition and multimodal interventions reduced hospital LoS (mean difference vs usual care: −1.81 days, 95% CI −2.31 to −1.31; −2.11 days, 95% CI −3.07 to −1.15; −1.67 days, 95% CI −2.31 to −1.03, respectively). Immunonutrition reduced infective complications (risk ratio (RR) 0.64 95% CI 0.40 to 1.01) and IMT, and exercise reduced postoperative pulmonary complications (RR 0.55, 95% CI 0.38 to 0.80, and RR 0.54, 95% CI 0.39 to 0.75, respectively). Smoking cessation interventions reduced wound infections (RR 0.28, 95% CI 0.12 to 0.64).ConclusionsSome prehabilitation interventions may reduce postoperative LoS and complications but the quality of the evidence was low.PROSPERO registration numberCRD42015019191.

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Section: Resultsmentioning

confidence: 99%

Pre-admission interventions (prehabilitation) to improve outcome after major elective surgery: a systematic review and meta-analysis

et al. 2021

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“…Unfortunately, only three studies reported LOS outcomes with respect to this intervention, each of insufficient power to detect a difference. 110,112 Equally unexpectedly, the insertion of prophylactic drainage was not associated with increased LOS. Avoidance of unnecessary drain insertion is generally recommended 5 and the authors hypothesise that the similar LOS observed among drained and undrained patients relates to study protocols designed to compare endpoints such as pain, development of collections, and drain outputs, at standard timepoints.…”

Section: Discussionmentioning

confidence: 93%

“…Three studies [110][111][112] were identified examining the effect of intensive versus standard preoperative education and none found differences in LOS or day case rate. This intervention was not amenable to meta-analysis as there were not enough studies for inclusion in either LOS or day case rate.…”

Section: Preoperative Educationmentioning

confidence: 99%

Systematic review and meta-analysis of factors which reduce the length of stay associated with elective laparoscopic cholecystectomy

Ryan

OʼConnell

Rogers

et al. 2021

HPB

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Background Laparoscopic cholecystectomy is a safe ambulatory procedure in appropriately selected patients; however, day case rates remain low. The objective of this systematic review and meta-analysis was to identify interventions which are effective in reducing the length of stay (LOS) or improving the day case rate for elective laparoscopic cholecystectomy. Methods Comparative English-language studies describing perioperative interventions applicable to elective laparoscopic cholecystectomy in adult patients and their impact on LOS or day case rate were included. Results Quantitative data were available for meta-analysis from 80 studies of 10,615 patients. There were an additional 17 studies included for systematic review. The included studies evaluated 14 peri-operative interventions. Implementation of a formal day case care pathway was associated with a significantly shorter LOS (MD = 24.9 h, 95% CI, 18.7–31.2, p < 0.001) and an improved day case rate (OR = 3.5; 95% CI, 1.5–8.1, p = 0.005). Use of non-steroidal anti-inflammatories, dexamethasone and prophylactic antibiotics were associated with smaller reductions in LOS. Conclusion Care pathway implementation demonstrated a significant impact on LOS and day case rates. A limited effect was noted for smaller independent interventions. In order to achieve optimal day case targets, a greater understanding of the effective elements of a care pathway and local barriers to implementation is required.

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“…Ayrıca bü girişimlerin hastaların semptom kontrolü ne ve o z bakımlarına katkı sag layacag ı dü şü nü lmektedir. GLK geçirecek hastalar, ameliyat o ncesi kapsamlı eg itim verildig inde evde karşılaşabilecekleri ag rı, bülantı-küsma, yara bakımı konülarında oto kontrol sag layarak kendi bakımlarını gerçekleştirebilirler ve kendilerini gü vende hissederler (26). Ameliyat Sonrası Bakım Cerrahi sonrası planlı ve kanıta dayalı hemşirelik yo netimi ile gelişebilecek pek çok komplikasyon o nlenebilmektedir (27).…”

Section: Günübi̇rli̇k Laparoskopi̇k Kolesi̇stektomi̇ Ve Bakim Ameliyat öNcesi Hasta Hazırlığıunclassified

Günübi̇rli̇k Laparaskopi̇k Kolesi̇stektomi̇de Bakim

Sürme

2020

Sağlık Bilimleri Dergisi

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Gü nü birlik cerrahi, gü nü birlik cerrahi kriterlerine üyan hastaların, elektif olarak cerrahi girişime alınmasını ve girişim sonrası aynı gü n hastaneden çıkışlarının gerçekleştirildig i girişimler olarak tanımlanmaktadır. Gü nü birlik olarak gerçekleştirilen ameliyatlardan birisi olan laparoskopik kolesistektomi, gü nü mü zde anestezi yo ntemlerinin, cerrahi tekniklerin ve bakım sistemlerinin gelişimi sonücü yaygın bir şekilde küllanılmaktadır. Gü nü birlik laparoskopik kolesistektomi minimal insizyon ve büna bag lı daha az ag rı, dü şü k stres tepkisi, komplikasyon oranlarının yatış yapılarak yü rü tü len laparoskopik kolesistektomiden farklı olmaması, yatış sü resinin kısa olması ve bü sayede hasta memnüniyetini arttırması gibi nedenlerle tü m dü nyada tercih edilmektedir. Hastalar ameliyat sonrası aynı gü n tabürcü edildikleri için ameliyat sonrası sık karşılaşılan ag rı, bülantı -küsma, kanama gibi semptomların dikkatlice izlenmesi, bü semptomların farmakolojik ve non farmakolojik yonetimi o nemli hemşirelik girişimleridir. Gü nü birlik laparoskopik kolesistektomi işlemi o ncesi hastaların gereksinimlerine ve gelişebilecek komplikasyonlara yo nelik kapsamlı eg itim verilmesi, iyileşme sü recinin kısalmasına, etkili bir semptom yo netimi sag lanmasına ve yeniden hastane yatışlarının o nlenmesine olanak sag lar. Bü makalede gü nü birlik laparoskopik kolesistektomi ilgili hemşirelik bakımını sünmak hedeflenmiştir.

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Evaluation of the Impact of Preoperative Education in Ambulatory Laparoscopic Cholecystectomy. A Prospective, Double-Blind Randomized Trial

Cited by 6 publications

References 23 publications

Pre-admission interventions (prehabilitation) to improve outcome after major elective surgery: a systematic review and meta-analysis

Pre-admission interventions (prehabilitation) to improve outcome after major elective surgery: a systematic review and meta-analysis

Systematic review and meta-analysis of factors which reduce the length of stay associated with elective laparoscopic cholecystectomy

Günübi̇rli̇k Laparaskopi̇k Kolesi̇stektomi̇de Bakim

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