Survey of Perioperative Practices in Gastric Cancer Surgery for Establishing an Enhanced Recovery After Surgery Program Across 10 Tertiary Hospitals in South Korea.

IF 3.8 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Ho-Jin Lee, Jeesun Kim, Bon-Wook Koo, Yun-Suhk Suh, Jung-Man Lee, Dong-Seok Han, Sang Hyun Hong, Han Hong Lee, Young Chul Yoo, Hyoung-Il Kim, Ji Yoon Rho, Hong Man Yoon, Ha-Yeon Kim, Hoon Hur, Hyae-Jin Kim, Chang In Choi, Boohwi Hong, Sang-Il Lee, Kibeom Park, Seung Wan Ryu, Do Joong Park
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Abstract

Purpose: This study aimed to identify the current perioperative management practices for gastric cancer surgery in South Korea and develop a consensus-driven Enhanced Recovery After Surgery (ERAS) protocol for a multicenter randomized controlled trial (RCT).

Materials and methods: A survey was conducted with 20 principal investigators, comprising one gastric surgeon and one anesthesiologist each, from 10 tertiary hospitals in South Korea who participated in a planned multicenter RCT. The survey included 41 questions regarding ERAS implementation and department-specific perioperative management practices. The responses were analyzed using descriptive statistics, and the findings were used to develop a consensus-driven ERAS protocol.

Results: A total of 20 participants completed the survey. Most respondents estimated the overall compliance rate with ERAS protocols for gastric cancer surgery to be 30%-50%. A major barrier to ERAS implementation is limited personnel resources. The survey revealed significant variability in perioperative practices-particularly in postoperative oral feeding protocols and expected discharge dates-across institutions. Most institutions practice water fasting from midnight before surgery, and the adoption rate of multimodal opioid-sparing analgesia is low. Based on these findings, an ERAS protocol was established through collaborative discussions to shorten perioperative fasting periods and implement multimodal opioid-sparing analgesia.

Conclusions: This study revealed significant variability in the perioperative management of gastric cancer surgery in South Korea. A consensus-driven ERAS protocol was established to standardize care and promote functional recovery. Its feasibility and effectiveness should be evaluated in an upcoming multicenter RCT.

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韩国10家三级医院胃癌手术围手术期实践调查:建立增强术后恢复计划
目的:本研究旨在确定目前韩国胃癌手术围手术期管理实践,并为一项多中心随机对照试验(RCT)制定共识驱动的增强术后恢复(ERAS)方案。材料和方法:对韩国10家三级医院的20名主要研究者进行调查,其中包括一名胃外科医生和一名麻醉师,他们参加了一项计划中的多中心随机对照试验。调查包括41个关于ERAS实施和科室围手术期管理实践的问题。使用描述性统计分析响应,并将研究结果用于制定共识驱动的ERAS协议。结果:共有20名参与者完成了调查。大多数应答者估计胃癌手术ERAS方案的总体依从率为30%-50%。人力资源有限是实施ERAS的主要障碍。调查揭示了各机构围手术期实践的显著差异,特别是在术后口服喂养方案和预期出院日期方面。大多数机构在手术前午夜开始禁食,多模式阿片类镇痛的采用率较低。基于这些发现,通过协作讨论建立了ERAS方案,以缩短围手术期禁食时间并实施多模式阿片类镇痛。结论:本研究揭示了韩国胃癌手术围手术期管理的显著差异。建立了共识驱动的ERAS方案,以规范护理并促进功能恢复。其可行性和有效性应在即将到来的多中心随机对照试验中进行评估。
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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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