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

Yıl 2024, Cilt: 8 Sayı: 3, 383 - 393

Burcu Küçükkaya , Mehtap Temiz

https://doi.org/10.46332/aemj.1451215

Öz

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.

Anahtar Kelimeler

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

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

• 1. Eroğlu K, Koç G. Jinekolojik kanser kontrolü ve hemşirelik. HUHEMFAD. 2014;1(2):77-90.
• 2. Global Cancer Observatory (GLOBOCAN). Global Cancer Statistics 2020. https://gco.iarc.fr/en. Erişim tarihi 26 Ocak, 2024.
• 3. Cancer Research UK. Ovarian Cancer Symptoms. 2016. http://www.cancerresearchuk.org/cancer-help/type/ovarian-cancer/about/ovarian-cancer-symptoms . Erişim tarihi 20 Şubat, 2024.
• 4. Della Corte L, Conte C, Palumbo M, et al. Hyperthermic Intraperitoneal Chemotherapy (HIPEC): New approaches and controversies on the treatment of advanced epithelial ovarian cancer-systematic review and meta-analysis. J Clin Med. 2023;12(22):7012.
• 5. Ghirardi V, Trozzi R, Scambia G, Fagotti A. Current and future trials about HIPEC in ovarian cancer. Bull Cancer. 2024;111(3):254-260.
• 6. Glockzin G, Piso P, Schlitt H. J. Surgical approach including hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastasis. Visceral Med. 2013;29(4):220-225.
• 7. Rotruck S, Wilson JT, McGuire J. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a case report. AANA J. 2014;82(2):140-143.
• 8. Solanki SL, Jhingan MAK, Saklani AP. Rebound hypothermia after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and cardiac arrest in immediate postoperative period: a report of two cases and review of literature. Pleura Peritoneum. 2020;5:20200126.
• 9. Wajekar AS, Solanki SL, Patil VP. Postoperative complications and critical care management after cytoreduction surgery and hyperthermic intraperitoneal chemotherapy: A systematic review of the literature. World J Crit Care Med. 2022;11(6):375-386.
• 10. Bakrin N, Cotte E, Golfier F, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for persistent and recurrent advanced ovarian carcinoma: a multicenter, prospective study of 246 patients. Ann Surg Oncol. 2012;19:4052-4058.
• 11. Huang F, Chia YY, Eng CL, et al. Evaluation of a preoperative clinic for women with gynecologic cancer. Clin. J. Oncol. Nurs. 2015;19(6):769-772.
• 12. Arakelian E, Gunningberg L, Larsson J, Norlén K, Mahteme H. Factors influencing early postoperative recovery after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. EJSO. 2011;37(10):897-903.
• 13. Stewart DE, Wong F, Cheung AM, et al. Information needs and decisional preferences among woman ovarian cancer. Gynecol Oncol. 2000;77(3):357-361.
• 14. Francescutti VA, Maciver AH, Stewart E, et al. Characterizing the patient experience of CS/HIPEC through ın-depth ınterviews with patients: ıdentification of key concepts in the development of a patient-centered program. Ann Surg Oncol. 2019;26(4):1063-1070.
• 15. Angioli R, Plotti F, Capriglione S, et al. The effects of giving patients verbal or written preoperative information in gynecologic oncology surgery: a randomized study and the medical-legal point of view. Eur J Obstet Gynecol Reprod Biol. 2014;177:67-71.
• 16. Martin AS, Abbott DE, Hanseman D, et al. Factors associated with readmission after cytoreductive surgery and hyperthermic ıntraperitoneal chemotherapy for peritoneal carcinomatosis. Ann Surg Oncol. 2016;23: 1941-1947.
• 17. Rouhi AD, Ghanem YK, Hoeltzel GD, et al. Quality and readability assessment of online patient information on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. J. Surg. Oncol. 2023;127(4): 699-705.
• 18. Hübner M, Kusamura S, Villeneuve L, et al. Guidelines for Perioperative Care in Cytoreductive Surgery (CRS) with or without hyperthermic IntraPEritoneal chemotherapy (HIPEC): Enhanced recovery after surgery (ERAS®) Society Recommendations- Part I: Preoperative and intraoperative management. EJSO. 2020;46(12):2292-2310.
• 19. Seibaek L, Blaakaer J, Petersen LK, Hounsgaard L. Ovarian cancer surgery: health and coping during the perioperative period, Support Care Cancer. 2013;21:575-582.
• 20. Egholm JW, Pedersen B, Møller AM, Adami J, Juhl CB, Tønnesen H. Perioperative alcohol cessation intervention for postoperative complications. Cochrane Database Syst Rev. 2018;11(11).
• 21. Albayrak S, Balcı S. Gençlerde madde bağımlılığı ve önlenmesi. JERN. 2014;11(2):30-37.
• 22. Tønnesen H, Nielsen PR, Lauritzen JB, Møller AM. Smoking and alcohol intervention before surgery: evidence for best practice. BJA. 2009;102(3):297-306.
• 23. Myers K, Hajek P, Hinds C, McRobbie H. Stopping smoking shortly before surgery and postoperative complications: a systematic review and meta-analysis. Arch. Intern. Med. 2011;171(11):983-989.
• 24. Warner DO. Preoperative smoking cessation: the role of the primary care provider. Mayo Clin. Proc. 2015;80(2):252-258.
• 25. Thomsen T, Villebro N, Møller AM. Interventions for preoperative smoking cessation. Cochrane Database Syst. Rev. 2014;(3):CD002294.
• 26. Rice VH, Heath L, Livingstone-Banks J, Hartmann-Boyce J. Nursing interventions for smoking cessation. Cochrane Database Syst Rev. 2017;12(12): CD001188.
• 27. Mathre ML. Alcohol tobacco and other drug problems in the community. In: Community and Public Health Nursing. Eds. 6. Ed. Holland:Mosby Elsevier. 2014: 848-874.
• 28. Shander A, Knight K, Thurer R, Adamson J, Spence R. Prevalence and outcomes of anemia in surgery: a systematic review of the literature. Am. J. Med. 2004;16(7):58-69.
• 29. Browning RM, Trentino K, Nathan EA, Hashemi N. Western Australian Patient Blood Management Program Preoperative anaemia is common in patients undergoing major gynaecological surgery and is associated with a five fold increased risk of transfusion, Aust N Z J Obstet Gynaecol. 2017;52(5):455-459.
• 30. Shelton KB. Hematological and immune disorders. Introduction to critical care nursing. 3rd ed. Philadelphia: W. B. Saunders Company; 2001:419-425.
• 31. Bogani G, Sarpietro G, Ferrandina G, et al. Enhanced recovery after surgery in gynecology oncology. Eur J Surg Oncol. 2021;47(5):952-959.
• 32. Nelson G, Bakkum-Gamez J, Kalogera E, et al. Guidelines for perioperative care in gynecologic/oncology: Enhanced recovery after surgery (ERAS) society recommendations 2019 update. Int J Gynecol Cancer. 2019;29(4):651-668.
• 33. Jamshidi S, Hejazi N, Zimorovat AR. Nutritional Status in Patients with Gastrointestinal Cancer in Comparison To Other Cancers In Shiraz, Southern Iran: a Case-Control Study [retracted in: World J Plast Surg. 2019 Jan;8(1):125]. World J Plast Surg. 2018;7(2):186-192.
• 34. Schiff JH, Frankenhauser S, Pritsch M, et al. The Anesthesia Preoperative Evaluation Clinic (APEC): a prospective randomized controlled trial assessing impact on consultation time, direct costs, patient education and satisfaction with anesthesia care. Minerva Anestesiol. 2010;76(7):491-499.
• 35. Weimann A, Braga M, Carli F, et al. European Society for Clinical Nutrition and Metabolism [ESPEN] guideline: Clinical nutrition in surgery. 2017;36(3):623-650.
• 36. Kim S, McClave SA, Martindale RG, Miller KR, Hurt RT. Hypoalbuminemia and Clinical Outcomes: What is the Mechanism behind the Relationship?. Am Surg. 2017;83(11):1220-1227.
• 37. Probst P, Ohmann S, Klaiber U, et al. Meta-analysis of immunonutrition in major abdominal surgery. Br J Surg. 2017;104(12):1594-1608.
• 38. Miralpeix E, Mancebo G, Gayete S, Corcoy M, Sole-Sedeno JM. Role and impact of multimodal prehabilitation for gynecologic oncology patients in an enhanced revovery after surgery (ERAS) Program. Int J Gynecol. 2019;29(8):1235-1243.
• 39. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and fraility in elderly people. CMAJ. 2005;173(5):489-495.
• 40. Levine EA, Stewart JH 4th, Shen P, Russell GB, Loggie BL, Votanopoulos KI. Intraperitoneal chemotherapy for peritoneal surface malignancy: experience with 1,000 patients. J Am Coll Surg. 2014;218(4):573-585.
• 41. Valle M, Federici O, Carboni F, et al. Postoperative infections after cytoreductive surgery and HIPEC for peritoneal carcinomatosis: proposal and results from a prospective protocol study of prevention, surveillance and treatment. Eur J Surg Oncol. 2014;40(8):950-956.
• 42. Noorani A, Rabey N, Walsh SR, Davies RJ. Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery. Br J Surg. 2010;97(11):1614-1620.
• 43. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195-283.
• 44. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection. JAMA Surg. 2017;152(8):784-791.
• 45. Cascales-Campos PA, Sánchez-Fuentes PA, Gil J, et al. Effectiveness and failures of a fast track protocol after cytoreduction and hyperthermic intraoperative intraperitoneal chemotherapy in patients with peritoneal surface malignancies. Surg Oncol. 2016;25(4): 349-354.
• 46. Rankovic VI, Masirevic VP, Pavlov MJ, et al. Hemodynamic and cardiovascular problems during modified hyperthermic intraperitoneal perioperative chemotherapy. Hepatogastroenterology. 2007;54(74): 364-366.
• 47. Casado D, López F, Martí R. Perioperative fluid management and major respiratory complications in patients undergoing esophagectomy. Dis Esophagus. 2010;23(7):523-528.
• 48. Raspé C, Flöther L, Schneider R, Bucher M, Piso P. Best practice for perioperative management of patients with cytoreductive surgery and HIPEC. Eur J Surg Oncol. 2017;43(6):1013-1027.
• 49. Jafari MD, Halabi WJ, Stamos MJ, et al. Surgical outcomes of hyperthermic intraperitoneal chemotherapy: analysis of the american college of surgeons national surgical quality improvement program. JAMA Surg. 2014;149(2):170-175.
• 50. Colantonio L, Claroni C, Fabrizi L, et al. A randomized trial of goal directed vs. standard fluid therapy in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. J Gastrointest Surg. 2015;19(4): 722-729.