Ioannidis Orestis, Koltsida Aggeliki, Anestiadou Elissavet, Ramirez Jose M, Fabbri Nicolò, Ubieto Javier Martínez, Feo Carlo Vittorio, Pesce Antonio, Rosetzka Kristyna, Arroyo Antonio, Kocián Petr, Sánchez-Guillén Luis, Bellosta Ana Pascual, Whitley Adam, Enguita Alejandro Bona, Teresa-Fernandéz Marta, Bitsianis Stefanos, Symeonidis Savvas
Fourth Department of Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital "George Papanikolaou", 57010 Thessaloniki, Greece.
Institute for Health Research Aragón, 50009 Zaragoza, Spain.
Medicina (Kaunas). 2025 May 26;61(6):978. doi: 10.3390/medicina61060978.
Hepatectomies play a crucial role in the multidisciplinary management of primary and secondary liver malignancies but are associated with significant risks, including 30-day mortality, morbidity, prolonged hospitalization, and increased resource utilization. Optimizing perioperative care remains a challenge; however, enhanced recovery programs have shown improved patient outcomes. The EUPEMEN (EUropean PErioperative MEdical Networking) protocol focuses on improving the perioperative management of liver resections through the establishment of interdisciplinary principles based on practical experience and theoretical frameworks from five European countries. This paper outlines the core elements of the EUPEMEN protocol, emphasizing strategies to minimize surgical stress, optimize perioperative care, and enhance postoperative recovery. The protocol is systematically designed to reduce postoperative mortality and morbidity, shorten hospital stays, and improve patient outcomes. The EUPEMEN guidelines address inconsistencies in surgical practice across Europe and are structured for implementation in various healthcare environments. "The protocol's approach is designed to support improvements in perioperative care standards in liver resections and may serve as a practical and efficient tool for healthcare professionals, pending further clinical validation. The EUPEMEN protocol offers a standardized, evidence-based framework to enhance perioperative management in hepatectomies. By integrating multidisciplinary principles, the main target is to eliminate complications, improve surgical outcomes, and promote faster recovery. Its implementation across diverse clinical settings may contribute to advancing perioperative care standards for liver resections in Europe.
肝切除术在原发性和继发性肝脏恶性肿瘤的多学科治疗中发挥着关键作用,但也伴随着重大风险,包括30天死亡率、发病率、住院时间延长以及资源利用增加。优化围手术期护理仍然是一项挑战;然而,强化康复计划已显示出能改善患者预后。EUPEMEN(欧洲围手术期医学网络)方案专注于通过基于五个欧洲国家的实践经验和理论框架确立跨学科原则,来改善肝切除术的围手术期管理。本文概述了EUPEMEN方案的核心要素,强调了将手术应激降至最低、优化围手术期护理以及促进术后康复的策略。该方案经过系统设计,旨在降低术后死亡率和发病率,缩短住院时间,并改善患者预后。EUPEMEN指南解决了欧洲各地手术实践中的不一致问题,并构建成可在各种医疗环境中实施的形式。“该方案的方法旨在支持提高肝切除术围手术期护理标准,并且在进一步临床验证之前,可能成为医疗专业人员实用且高效的工具。EUPEMEN方案提供了一个标准化且基于证据的框架,以加强肝切除术中的围手术期管理。通过整合多学科原则,主要目标是消除并发症、改善手术效果并促进更快康复。在不同临床环境中实施该方案可能有助于提高欧洲肝切除术围手术期护理标准。