Pre- and postoperative stoma education and guidance within an enhanced recovery after surgery (ERAS) programme reduces length of hospital stay in colorectal surgery

被引：108

作者：

Forsmo, H. M. ^{[1
,2
]}

Pfeffer, F. ^{[1
,2
]}

Rasdal, A. ^{[1
]}

Sintonen, H. ^{[3
]}

Koerner, H. ^{[2
,4
]}

Erichsen, C. ^{[1
]}

机构：

[1] Haukeland Hosp, Dept Gastrointestinal & Emergency Surg, N-5021 Bergen, Norway

[2] Univ Bergen, Dept Clin Med, N-5020 Bergen, Norway

[3] Univ Helsinki, Dept Publ Hlth, Helsinki, Finland

[4] Stavanger Univ Hosp, Dept Gastrointestinal Surg, Stavanger, Norway

来源：

INTERNATIONAL JOURNAL OF SURGERY | 2016年 / 36卷

关键词：

Colorectal surgery; Stoma; Education; ERAS; Complications; QUALITY-OF-LIFE; CONTROLLED-TRIAL; SITE MARKING; RESECTION; REHABILITATION; COMPLICATIONS; OSTOMATES; OUTCOMES; PATHWAY;

D O I：

10.1016/j.ijsu.2016.10.031

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Introduction: Stoma formation delays discharge after colorectal surgery. Stoma education is widely recommended, but little data are available regarding whether educational interventions are effective. The aim of this prospective study was to investigate whether an enhanced recovery after surgery (ERAS) programme with dedicated ERAS and stoma nurse specialists focusing on counselling and stoma education can reduce the length of hospital stay, re-admission, and stoma-related complications and improve health-related quality of life (HRQoL) compared to current stoma education in a traditional standard care pathway. Methods: In a single-center study 122 adult patients eligible for laparoscopic or open colorectal resection who received a planned stoma were treated in either the ERAS program with extended stoma education (n = 61) or standard care with current stoma education (n = 61). The primary endpoint was total postoperative hospital stay. Secondary endpoints were postoperative hospital stay, major or minor morbidity, early stoma-related complications, health-related quality of life, re-admission rate, and mortality. HRQoL was measured by the generic 15D instrument. Results: Total hospital stay was significantly shorter in the ERAS group with education than the standard care group (median [range], 6 days [2-21 days] vs. 9 days [5-45 days]; p < 0.001). Regarding overall major and minor morbidity, re-admission rate, HRQoL, stoma-related complications and 30-day mortality, the two treatment groups exhibited similar outcomes. Conclusion: Patients receiving a planned stoma can be included in an ERAS program. Pre-operative and postoperative stoma education in an enhanced recovery programme is associated with a significantly shorter hospital stay without any difference in re-admission rate or early stoma-related complications. (C) 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

引用

页码：121 / 126

页数：6

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