KOLOREKTAL CERRAHİ SONRASI HIZLANDIRILMIŞ İYİLEŞME PROTOKOLÜ: SİSTEMATİK DERLEME

Yıl 2016, Cilt: 5 Sayı: 3, 120 - 132, 01.07.2016

Müjgan Solak Kabataş Türkan Özbayır

Öz

Cerrahi sonrası hızlandırılmış iyileşme (Enhanced Recovery After Surgery; ERAS) protokolleri ameliyat öncesi organ fonksiyonlarını korumak ve cerrahi sonrası stres yanıtı azaltarak erken iyileşme elde etmek için tasarlanmış  bakım modelleridir. Bu çalışmada, kolorektal cerrahide ERAS  protokolü bileşenlerininuygulanmasının hastanede kalış süresi ve  ameliyat sonrası komplikasyon gelişme riskine etkisini inceleyen araştırmaların  sistematik olarak değerlendirilmesi amaçlandı.
Araştırma Ağustos- Ekim 2015 tarihinde, “Enhanced Recovery After Surgery”, “Enhanced Recovery After Colorectal Surgery”,“ERAS”  “Colorectal Surgery” anahtar kelimeleri ile, “PUBMED”, “EBSCOHOST”, “WEB OF SCİENCE” ve  “GOOGLE” arama motorları kullanılarak yapıldı. Çalışmada 2010-2015 yılları arasında yayın dili  ingilizce olan ve tam metnine ulaşılan 17695 literatür incelendi. Araştırmaya randomize kontrollü olan, randomize kontrollü olmayan ve deneysel yapılan çalışmalardan ameliyat öncesi, sırası ve sonrası ERAS protokollerinin en az dört bileşenini içeren 16 çalışma dahil edildi. Veriler, araştırmacılar tarafından geliştirilen standart bir veri özetleme formu kullanılarak analiz edildi.
Çalışmaya dahil edilen ERAS protokolü ile izlenen hastaların hastane ortalama kalış süresinin ortalama 5.8±1.41 gün olduğu,  geleneksel bakım ile izlenen hastaların ise hastane ortalama kalış süresinin 8.7±3.17 olduğu saptanmıştır. Çalışmamızda ERAS protokolü ile izlenen hastalarda %5 ile  %40, geleneksel bakım ile izlenen hastalarda ise %9.5 ile %60 arasında komplikasyon geliştiği belirtilmektedir. Sonuç olarak, kolorektal cerrahide geleneksel bakıma göre ERAS protokolü ile bakım verilen hastaların hastanede kalış süresinin ve komplikasyonların görülme oranının azaldığı belirlendi.

Anahtar Kelimeler

Kolorektal Cerrahi, Hızlandırılmış İyileşme Protokolleri, ERAS

ENHANCED RECOVERY AFTER SURGERY (ERAS) PROTOCOLS AFTER COLORECTAL SURGERY : A SYSTEMATIC REVIEW

Öz

Enhanced Recovery After Surgery (ERAS) protocols are care models designed to protect pre-operative organ functions and to reduce the post-operative stress response in order to secure early recovery. The aim of this study was to systematically evaluate studies examining the effect application of components of ERAS protocols on the length of stay in hospital and the risk of post-operative complications in patients undergoing colorectal surgery.
The study was conducted between August and October 2015 using the keywords “Enhanced Recovery After Surgery”, “Enhanced Recovery After Colorectal Surgery”, “ERAS” and “Colorectal Surgery” in the PUBMED, EBSCOHOST, WEB OF SCİENCE and GOOGLE search engines.  The full texts of 17695 articles published in English between 2010 and 2015 were accessed and examined.  Sixteen randomly controlled, non-randomly controlled, and experimentally conducted studies which included at least four components of ERAS pre-operative, intra-operative and post-operative protocols studies were included in the study.  Data  was analyzed by using a standard data summary form designed by the researchers.
It was determined that  the length of stay in hospital of patients monitoring with ERAS protokols was aveage 5.8±1.41 day whereas patients monitoring with traditional care was 8.7±3.17 day.ın this study, the patients monitoring with ERAS protokols with between 5%-40% , patients monitoring with tradional care with between 9.5%-60% complication were observed. As a result; It was found that in comparison with traditional care, ERAS protocols and care reduced the length of stay in hospital and the rate of complications in colorectal cancer in patients to whom they were given.

Anahtar Kelimeler

Colorectal Surgery, Enhanced Recovery After Colorectal Surgery, ERAS

Kaynakça

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