ERAS Protocol and Evidence-Based Practices in Postoperative Care and Management of Patients with Ovarian Cancer Undergoing Hyperthermic Intraperitoneal Chemotherapy Procedure After Cytoreductive Surgery

Year 2025, Volume: 7 Issue: 1, 124 - 136, 25.02.2025

Mehtap Temiz , Burcu Küçükkaya

https://doi.org/10.52827/hititmedj.1512983

Abstract

A post-surgical accelerated recovery protocol is a multifaceted set of evidence-based guidelines for the appropriate treatment and care of patients. This protocol is incorporated into management processes after many different major surgeries, including surgery for gynecologic cancers such as ovarian cancer. Postoperative monitoring and care is of great importance, especially in procedures with a high risk of complications such as hyperthermic intraperitoneal chemotherapy after cytoreductive surgery. Especially in patients undergoing this procedure, components of the postoperative accelerated recovery protocol such as avoiding unnecessary nasogastric tube administration, prevention of ileus, multimodal analgesia, early oral intake, monitoring of blood glucose levels, thrombophylaxis, early mobilization, prevention of nausea and vomiting are of great importance. In this direction, it is recommended that women's health nurses should include the postoperative accelerated recovery protocol and evidence-based practices in nursing care and management processes and conduct scientific studies with high level of evidence in providing holistic care to the patient after hyperthermic intraperitoneal chemotherapy after cytoreductive surgery. This review aims to traditionally review the postoperative accelerated recovery protocol, evidence-based practices, and the roles and responsibilities of nurses in the postoperative care and management of ovarian cancer patients undergoing hyperthermic intraperitoneal chemotherapy procedure after cytoreductive surgery.

Keywords

Cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, ovarian cancer, ERAS, evidence-based practices

Ethical Statement

Ethics committee approval is not required. This study was presented as a poster presentation at the 8th International 19th National Nursing Congress held in Ankara between 25-28 September 2024.

Sitoredüktif Cerrahi Sonrası Hipertermik İntraperitoneal Kemoterapi Prosedürü Uygulanan Over Kanserli Hastanın Postoperatif Bakım ve Yönetiminde ERAS Protokolü ve Kanıta Dayalı Uygulamalar

Abstract

Cerrahi sonrası hızlandırılmış iyileşme protokolü, hastaların uygun şekilde tedavi ve bakımının sağlanabilmesi için hazırlanan çok yönlü kanıta dayalı uygulamaların yer aldığı kılavuzlardır. Bu protokol, over kanseri gibi jinekolojik kanserlerin cerrahisi de dâhil olmak üzere birçok farklı majör cerrahi sonrasındaki yönetim süreçlerine dâhil edilmektedir. Özellikle sitoredüktif cerrahi sonrası hipertermik intraperitoneal kemoterapi gibi komplikasyon riskinin yüksek olduğu işlemlerde postoperatif izlem ve bakım büyük öneme sahiptir. Özellikle, bu işlemin uygulandığı hastalarda, gereksiz nazogastrik tüp uygulamasından kaçınılması, ileusun önlenmesi, multimodal analjezi uygulanması, erken oral alım, kan glikoz değerinin izlemi, trombofilaksi, erken mobilizasyon, bulantı ve kusmanın önlenmesi gibi cerrahi sonrası hızlandırılmış iyileşme protokolü bileşenleri büyük önem taşımaktadır. Bu doğrultuda, kadın sağlığı hemşirelerinin, sitoredüktif cerrahi sonrası hipertermik intraperitoneal kemoterapi sonrası hastaya bütüncül bakım vermede cerrahi sonrası hızlandırılmış iyileşme protokolünü ve kanıta dayalı uygulamaları hemşirelik bakım ve yönetim süreçlerine dahil edilmesi ve kanıt düzeyi yüksek bilimsel çalışmalar yapması önerilmektedir. Bu derlemede, sitoredüktif cerrahi sonrası hipertermik intraperitoneal kemoterapi prosedürü uygulanan over kanserli hastanın postoperatif dönemde bakım ve yönetiminde cerrahi sonrası hızlandırılmış iyileşme protokolü, kanıta dayalı uygulamalar ile hemşirelerin rol ve sorumluluklarını geleneksel olarak derlemektir.

Keywords

Sitoredüktif cerrahi, hipertermik intraperitoneal kemoterapi, over kanseri, ERAS, kanıta dayalı uygulamalar

Ethical Statement

Makale Derleme türünde olduğundan etik kurul onayına gerek yoktur. Bu çalışma, 25-28 Eylül 2024 tarihleri arasında Ankara’da düzenlenen 8. Uluslararası 19. Ulusal Hemşirelik Kongresi’nde poster bildiri olarak sunulmuştur.

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