重大上消化道肿瘤切除术中护理流程对术后结局的作用：范围综述方案。

Role of intraoperative processes of care during major upper gastrointestinal oncological resection in postoperative outcomes: a scoping review protocol.

机构信息

Department of Surgery, Division of General Surgery, University of Toronto, Toronto, Ontario, Canada.

Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2023 Jul 4;13(7):e068339. doi: 10.1136/bmjopen-2022-068339.

DOI:10.1136/bmjopen-2022-068339

PMID:37407044

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10335411/

Abstract

INTRODUCTION

Optimal delivery and organisation of care is critical for surgical outcomes and healthcare systems efficiency. Anaesthesia volumes have been recently associated with improved postoperative recovery outcomes; however, the mechanism is unclear. Understanding the individual processes of care (interventions received by the patient) is important to design effective systems that leverage the volume-outcome association to improve patient care. The primary objective of this scoping review is to systematically map the evidence regarding intraoperative processes of care for upper gastrointestinal cancer surgery. We aim to synthesise the quantity, type, and scope of studies on intraoperative processes of care in adults who undergo major upper gastrointestinal cancer surgeries (oesophagectomy, hepatectomy, pancreaticoduodenectomy, and gastrectomy) to better understand the volume-outcome relationship for anaesthesiology care.

METHODS AND ANALYSIS

This scoping review will follow the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension framework for scoping reviews. We will systematically search MEDLINE, Embase and Cochrane databases for original research articles published after 2010 examining postoperative outcomes in adult patients undergoing either: oesophagectomy, hepatectomy, pancreaticoduodenectomy, or gastrectomy, which report at least one intraoperative processes of care (intervention or framework) applied by anaesthesia or surgery. The data from included studies will be extracted, charted, and summarised both quantitatively and qualitatively through descriptive statistics and narrative synthesis.

ETHICS AND DISSEMINATION

No ethics approval is required for this scoping review. Results will be disseminated through publication targeted at relevant stakeholders in anaesthesiology and cancer surgery.

TRIAL REGISTRATION NUMBER

10.17605/OSF.IO/392UG; https://archive.org/details/osf-registrations-392ug-v1.

摘要

简介

手术结果和医疗系统效率的关键在于提供最佳的医疗服务和组织管理。最近，麻醉量与术后恢复结果的改善有关；然而，其机制尚不清楚。了解护理的各个过程（患者接受的干预措施）对于设计有效的系统以利用量效关联来改善患者护理非常重要。本研究旨在系统地绘制有关上消化道癌症手术围手术期护理过程的证据。我们旨在综合关于接受重大上消化道癌症手术（食管切除术、肝切除术、胰十二指肠切除术和胃切除术）的成年人围手术期护理过程的研究数量、类型和范围，以更好地理解麻醉学护理的量效关系。

方法和分析

本综述将遵循 Arksey 和 O'Malley 框架以及系统评价和荟萃分析的首选报告项目（PRISMA）扩展框架进行。我们将系统地搜索 MEDLINE、Embase 和 Cochrane 数据库，以查找 2010 年后发表的原始研究文章，这些文章研究了接受以下手术的成年患者的术后结果：食管切除术、肝切除术、胰十二指肠切除术或胃切除术，这些研究报告了至少一项由麻醉或手术实施的围手术期护理过程（干预措施或框架）。将从纳入研究中提取、图表和总结数据，并通过描述性统计和叙述性综合进行定量和定性总结。