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中低收入国家(LMIC)基层和二级医院择期腹部和骨盆手术围手术期护理指南:术后加速康复(ERAS)协会推荐。

Guidelines for Perioperative Care in Elective Abdominal and Pelvic Surgery at Primary and Secondary Hospitals in Low-Middle-Income Countries (LMIC's): Enhanced Recovery After Surgery (ERAS) Society Recommendation.

机构信息

Division of Global Surgery, University of Cape Town, Anzio Road, Observatory, Cape Town, Western Cape, South Africa.

Department of Anesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Anzio Road, Observatory, Cape Town, Western Cape, South Africa.

出版信息

World J Surg. 2022 Aug;46(8):1826-1843. doi: 10.1007/s00268-022-06587-w. Epub 2022 May 31.

Abstract

BACKGROUND

This is the first Enhanced Recovery After Surgery (ERAS®) Society guideline for primary and secondary hospitals in low-middle-income countries (LMIC's) for elective abdominal and gynecologic care.

METHODS

The ERAS LMIC Guidelines group was established by the ERAS® Society in collaboration with different representatives of perioperative care from LMIC's. The group consisted of seven members from the ERAS® Society and eight members from LMIC's. An updated systematic literature search and evaluation of evidence from previous ERAS® guidelines was performed by the leading authors of the Colorectal (2018) and Gynecologic (2019) surgery guidelines (Gustafsson et al in World J Surg 43:6592-695, Nelson et al in Int J Gynecol Cancer 29(4):651-668). Meta-analyses randomized controlled trials (RCTs), prospective and retrospective cohort studies from both HIC's and LMIC's were considered for each perioperative item. The members in the LMIC group then applied the current evidence and adapted the recommendations for each intervention as well as identifying possible new items relevant to LMIC's. The Grading of Recommendations, Assessment, Development and Evaluation system (GRADE) methodology was used to determine the quality of the published evidence. The strength of the recommendations was based on importance of the problem, quality of evidence, balance between desirable and undesirable effects, acceptability to key stakeholders, cost of implementation and specifically the feasibility of implementing in LMIC's and determined through discussions and consensus.

RESULTS

In addition to previously described ERAS® Society interventions, the following items were included, revised or discussed: the Surgical Safety Checklist (SSC), preoperative routine human immunodeficiency virus (HIV) testing in countries with a high prevalence of HIV/AIDS (CD4 and viral load for those patients that are HIV positive), delirium screening and prevention, COVID 19 screening, VTE prophylaxis, immuno-nutrition, prehabilitation, minimally invasive surgery (MIS) and a standardized postoperative monitoring guideline.

CONCLUSIONS

These guidelines are seen as a starting point to address the urgent need to improve perioperative care and to effect data-driven, evidence-based care in LMIC's.

摘要

背景

这是第一份增强术后康复(ERAS®)学会针对中低收入国家(LMIC)择期腹部和妇科护理的初级和二级医院的指南。

方法

ERAS LMIC 指南小组由 ERAS®学会与来自 LMIC 的围手术期护理的不同代表合作成立。该小组由来自 ERAS®学会的七名成员和来自 LMIC 的八名成员组成。由结直肠(2018 年)和妇科(2019 年)手术指南的主要作者(Gustafsson 等人在 World J Surg 43:6592-695,Nelson 等人在 Int J Gynecol Cancer 29(4):651-668)进行了最新的系统文献检索和对以前 ERAS®指南证据的评估。对于每个围手术期项目,考虑了来自高收入国家(HIC)和中低收入国家(LMIC)的随机对照试验(RCT)、前瞻性和回顾性队列研究。LMIC 组的成员随后应用当前证据,并针对每项干预措施调整建议,以及确定与 LMIC 相关的可能新项目。使用推荐评估、制定与评价系统(GRADE)方法来确定已发表证据的质量。建议的强度基于问题的重要性、证据质量、理想效果和不良效果之间的平衡、对主要利益相关者的可接受性、实施成本以及特别是在 LMIC 实施的可行性,并通过讨论和达成共识来确定。

结果

除了以前描述的 ERAS®学会干预措施外,还包括、修订或讨论了以下项目:手术安全检查表(SSC)、在艾滋病毒/艾滋病(HIV/AIDS)高发国家常规术前人类免疫缺陷病毒(HIV)检测(CD4 和病毒载量,对于 HIV 阳性患者)、谵妄筛查和预防、COVID-19 筛查、静脉血栓栓塞症(VTE)预防、免疫营养、康复前治疗、微创外科(MIS)和标准化术后监测指南。

结论

这些指南被视为解决迫切需要改善围手术期护理并在 LMIC 中实施数据驱动、基于证据的护理的起点。

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本文引用的文献

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ESPEN practical guideline: Clinical nutrition in surgery.
Clin Nutr. 2021 Sep;40(9):5071. doi: 10.1016/j.clnu.2021.07.012. Epub 2021 Jul 10.
3
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Clin Nutr. 2021 Jul;40(7):4745-4761. doi: 10.1016/j.clnu.2021.03.031. Epub 2021 Apr 19.
6
Inadvertent perioperative hypothermia.
BJA Educ. 2018 Aug;18(8):227-233. doi: 10.1016/j.bjae.2018.05.003. Epub 2018 Jun 28.
7
Compromised Gut Associated Lymphoid Tissue is a Risk Factor for Postoperative Septic Complications in HIV-Seropositive Trauma Patients.
World J Surg. 2021 Apr;45(4):1006-1013. doi: 10.1007/s00268-020-05899-z. Epub 2021 Jan 12.
8
Improving perioperative brain health: an expert consensus review of key actions for the perioperative care team.
Br J Anaesth. 2021 Feb;126(2):423-432. doi: 10.1016/j.bja.2020.10.037. Epub 2021 Jan 4.
9
Efficacy and Safety Profile of Rectus Sheath Block in Adult Laparoscopic Surgery: A Meta-analysis.
J Surg Res. 2021 May;261:10-17. doi: 10.1016/j.jss.2020.12.003. Epub 2020 Dec 30.
10
Surgery and COVID-19.
JAMA. 2020 Sep 22;324(12):1151-1152. doi: 10.1001/jama.2020.15191.

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