Prospective study of patient satisfaction with enhanced recovery after surgery (ERAS) protocol in the immediate post-operative period in gynaecological oncology.


Journal

The Australian & New Zealand journal of obstetrics & gynaecology
ISSN: 1479-828X
Titre abrégé: Aust N Z J Obstet Gynaecol
Pays: Australia
ID NLM: 0001027

Informations de publication

Date de publication:
08 2021
Historique:
revised: 22 02 2021
received: 26 10 2020
accepted: 19 03 2021
pubmed: 24 4 2021
medline: 7 9 2021
entrez: 23 4 2021
Statut: ppublish

Résumé

Enhanced recovery after surgery (ERAS) is a multimodal protocol which aims to facilitate faster discharge from hospital and recovery after surgery by minimising physiological and physical stress on the body before, during and after surgery. The aim of this study is to evaluate patient satisfaction while being managed with the ERAS pathway and to determine whether it is an acceptable model of care in this respect. The study is an observational study of patient satisfaction in ERAS in gynaecological oncology. Patients who underwent laparoscopy or laparotomy for malignancy or suspected malignancy were asked to complete a validated questionnaire (EORTC IN-PATSAT32) prior to discharge from hospital after surgery. There were 113 (75.33%) patients recruited out of 150 patients who were approached. There were 68 cases of laparotomy and 45 cases of laparoscopy. There were no statistically significant differences between baseline characteristics of responders and non-responders in both the laparotomy and the laparoscopy group. Patients reported high levels of satisfaction, with a mean score for general satisfaction of 92.2 (SD 11.44 ± 1.387) in the laparotomy group and 92.4 (SD 10.69 ± 1.594) for the laparoscopy group. The results of our study reflect high levels of patient satisfaction in both the laparotomy and laparoscopy groups. This could be attributed to a strong focus on discharge planning through a multi-disciplinary approach, specifically addressing key aspects to recovery from initial consultation. The study reflects the successful implementation of an ERAS protocol with gynaecological oncological surgery in this unit.

Sections du résumé

BACKGROUND
Enhanced recovery after surgery (ERAS) is a multimodal protocol which aims to facilitate faster discharge from hospital and recovery after surgery by minimising physiological and physical stress on the body before, during and after surgery.
AIMS
The aim of this study is to evaluate patient satisfaction while being managed with the ERAS pathway and to determine whether it is an acceptable model of care in this respect.
MATERIALS AND METHODS
The study is an observational study of patient satisfaction in ERAS in gynaecological oncology. Patients who underwent laparoscopy or laparotomy for malignancy or suspected malignancy were asked to complete a validated questionnaire (EORTC IN-PATSAT32) prior to discharge from hospital after surgery.
RESULTS
There were 113 (75.33%) patients recruited out of 150 patients who were approached. There were 68 cases of laparotomy and 45 cases of laparoscopy. There were no statistically significant differences between baseline characteristics of responders and non-responders in both the laparotomy and the laparoscopy group. Patients reported high levels of satisfaction, with a mean score for general satisfaction of 92.2 (SD 11.44 ± 1.387) in the laparotomy group and 92.4 (SD 10.69 ± 1.594) for the laparoscopy group.
CONCLUSIONS
The results of our study reflect high levels of patient satisfaction in both the laparotomy and laparoscopy groups. This could be attributed to a strong focus on discharge planning through a multi-disciplinary approach, specifically addressing key aspects to recovery from initial consultation. The study reflects the successful implementation of an ERAS protocol with gynaecological oncological surgery in this unit.

Identifiants

pubmed: 33890284
doi: 10.1111/ajo.13361
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

591-598

Informations de copyright

© 2021 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Références

Brédart A, Bottomley A, Blazeby J et al. An international prospective study of the EORTC cancer in-patient satisfaction with care measure (EORTC IN-PATSAT32). Eur J Cancer 2005; 41(14): 2120-2131.
Sidhu V, Lancaster L, Elliott D, Brand A. Implementation and audit of ‘Fast-Track Surgery’ in gynaecological oncology surgery. Aust N Z J Obstet Gynaecol 2012; 52(4): 371-376.
Carter J, Philp S, O’Connell R. A 5-year review of gynaecological oncology patients managed by a fast track surgery program. Int J Clin Med 2014; 05(01): 36-41.
Myriokefalitaki E, Smith M, Ahmed A. Implementation of enhanced recovery after surgery (ERAS) in gynaecological oncology. Arch Gynecol Obstet 2015; 294(1): 137-143.
Spanjersberg WR, Reurings J, Keus F, van Laarhoven CJHM. Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst Rev 2011; (2). http://dx.doi.org/10.1002/14651858.cd007635.pub2
Sturm L, Cameron A. Brief review: Fast-track surgery and enhanced recovery after surgery (ERAS) programs. Stepney, S. Aust.: ASERNIP-S; 2009.
Philp S, Carter J, Barnett C et al. Patientsʼ perspectives of fast-track surgery and the role of the fast-track clinical nurse consultant in gynecological oncology. Holist Nurs Pract 2015; 29(3): 158-166.
Philp S, Carter J, Pather S et al. Patients' satisfaction with fast-track surgery in gynaecological oncology. Eur J Cancer Care 2014; 24(4): 567-573.
Lu D, Wang X, Shi G. Perioperative enhanced recovery programmes for gynaecological cancer patients. Cochrane Database Syst Rev 2015; (3). http://dx.doi.org/10.1002/14651858.cd008239.pub4
Nelson G, Kalogera E, Dowdy S. Enhanced recovery pathways in gynecologic oncology. Gynecol Oncol 2014; 135(3): 586-594.
Rooth C, Sidhu A. Implementing enhanced recovery in gynaecology oncology. Br J Nurs 2012; 21(Sup7): S4-S15.

Auteurs

Dhivya Thangavel (D)

Westmead Centre of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia.

Bassem Gerges (B)

Sydney West Advanced Pelvic Surgery, Blacktown Hospital, Sydney, New South Wales, Australia.

Alison Brand (A)

Westmead Centre of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia.
University of Sydney, Sydney, New South Wales, Australia.

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