Evidence-Based Practices and ERAS Protocol in Nurse Roles and Responsibilities in Preoperative Period Management in Hyperthermic Intraperitoneal Chemotherapy Procedure After Cytoreductive Surgery Planned for a Patient with Ovarian Cancer: Traditional Review

Abstract

The Enhanced Recovery After Surgery (ERAS) protocol refers to multifaceted evidence-based interventions applied to reduce the duration of hospital stay and the risk of complications for patients after the surgical procedure. In this context, it is effective in different types of major surgery, including surgery of gynecological cancers. Especially since the Hyperthermic Intraperitoneal Chemotherapy After Cytoreductive Surgery (SRCHIPEK) procedure is a major and complex procedure with high complication, morbidity and mortality rates, preparation and care in the preoperative period are of great importance. For patients planned for SRCHIPEC, gynecology nurses have responsibilities such as informing and counseling the patient with the ERAS protocol approach within the scope of evidence-based practices, teaching healthy lifestyle behaviors, evaluating nutrition and anemia status, ensuring immunonutrition, assessing cardiac risk and function, and avoiding unnecessary premedication, monitoring sedative/anxiolytic use and side effects, preventing long-term fasting before the procedure with planned preoperative preparations, maintaining and frequent monitoring of normothermia and normoglycemia. Thus, the incidence of complications in women with ovarian cancer who have undergone SRCHIPEC will decrease, patients will be able to meet their basic needs independently, they will be able to be discharged earlier, and therefore they will be able to return to social life more quickly. The aim of this review is to examine the evidence-based practices used in the preoperative management of the hyperthermic intraperitoneal chemotherapy procedure after cytoreductive surgery, which is planned to be applied to patients with ovarian cancer, and the roles and responsibilities of nurses in the ERAS protocol.

Keywords

• abdominal cavity
• cell reducing operation
• gynecological neoplasm
• heated chemotherapeutic drug
• nursing care

Over Kanserli Hastaya Uygulanması Planlanan Sitoredüktif Cerrahi Sonrası Hipertermik İntraperitoneal Kemoterapi Prosedüründe Preoperatif Dönem Yönetiminde Hemşire Rol ve Sorumluluklarında Kanıta Dayalı Uygulamalar ve ERAS Protokolü: Geleneksel Derleme

Abstract

Cerrahi Sonrası Hızlandırılmış İyileşme (Enhanced Recovery After Surgery; ERAS) protokolü, hastaların cerrahi işlem sonrasında hastanede kalış süresini ve komplikasyon riskini azaltmak için uygulanan çok yönlü kanıta dayalı müdahaleleri ifade etmektedir. Bu kapsamda, jinekolojik kanserlerin cerrahisi de dahil olmak üzere farklı majör cerrahi türlerinde etkili olmaktadır. Özellikle Sitoredüktif Cerrahi Sonrası Hipertermik İntraperitoneal Kemoterapi (SRCHİPEK) prosedürünün komplikasyon, morbidite ve mortalite oranı yüksek, majör ve kompleks bir işlem olması nedeniyle preoperatif dönemde hazırlık ve bakım büyük öneme sahiptir. SRCHİPEK planlanan hastalar için kadın hastalıkları hemşirelerinin kanıta dayalı uygulamalar kapsamında ERAS protokolü yaklaşımı ile hastanın bilgilendirilmesi ve danışmanlık yapılması, sağlıklı yaşam biçim davranışlarının kazandırılması, beslenme ve anemi durumunun değerlendirilmesi, immünonütrisyonun sağlanması, kardiyak risk ve fonksiyonun değerlendirilmesi, gereksiz premedikasyon uygulamasından kaçınılması, sedatif/anksiyolitik kullanımının ve yan etkilerinin izlenmesi, ameliyat öncesi planlanan hazırlıklar ile işlem öncesi uzun süre aç kalmanın önlenmesi, normotermi ve normogliseminin sürdürülmesi ve sık takibi gibi sorumlulukları bulunmaktadır. Böylelikle SRCHİPEK uygulanmış over kanserli kadınlarda görülen komplikasyon insidansı azalacak, hastalar temel ihtiyaçlarını bağımsız olarak karşılayabilir hale gelecek, daha erken taburcu olabilecek ve dolayısıyla sosyal yaşama daha hızlı dönebileceklerdir. Bu derlemede amaç, over kanserli hastalara uygulanması planlanan sitoredüktif cerrahi sonrası hipertermik intraperitoneal kemoterapi prosedüründe preoperatif dönem yönetiminde kullanılan kanıta dayalı uygulamalar ve ERAS protokolünde hemşirelerin rol ve sorumluluklarını incelemektir.

Keywords

• abdominal boşluk
• hemşirelik bakımı
• hücre azaltıcı operasyon
• ısıtılmış kemoterapötik ilaç
• jinekolojik neoplazm

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