{"title":"Nursing strategies after pancreaticoduodenectomy: continuity of care combined with immunomodulatory nutrition.","authors":"Xiaodong Feng, Wei Li, Yufu Tang, Lei Han, Ting Bi, Wei Zhang, Yuqing Miao","doi":"10.3389/fsurg.2025.1650974","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pancreaticoduodenectomy (PD) is a highly invasive procedure with a long operation time, resulting in a high incidence of postoperative complications. The quality of patient care remains a key factor in improving prognosis. This study aimed to evaluate the impact of continuity of care combined with immunomodulatory nutrition on the postoperative recovery and quality of life of patients undergoing PD surgery.</p><p><strong>Methods: </strong>This was a randomized controlled study involving 120 patients who underwent PD surgery at our hospital between February 2022 and February 2024. The patients were randomly divided into the conventional care group (CG) and the intervention group (IG), with the latter receiving continuity of care combined with arginine-rich immunonutritional support. The main observation indicators included survival analysis, recovery of gastrointestinal function, length of hospital stay, nutritional status, immune function, postoperative complications, negative emotions and quality of life.</p><p><strong>Results: </strong>There was no significant difference in the overall survival rate between the two groups. Compared with the CG, the IG had shorter length of hospital stay, better recovery of gastrointestinal function, better improvements of nutritional indicators such as ALB and PAB, lower levels of pro-inflammatory factors TNF-α, IL-6 and CRP, better improvement of CD4<sup>+</sup>/CD8<sup>+</sup> ratio, lower incidence of postoperative complications, lower SAS and SDS scores and better quality of life.</p><p><strong>Conclusion: </strong>Continuity of care combined with immunomodulatory nutrition provides a strong rationale for postoperative care of PD, and is worthy of clinical promotion and practice. More clinical cases and long-term follow-ups are needed to further verify its effectiveness.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1650974"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484049/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1650974","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
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Abstract
Background: Pancreaticoduodenectomy (PD) is a highly invasive procedure with a long operation time, resulting in a high incidence of postoperative complications. The quality of patient care remains a key factor in improving prognosis. This study aimed to evaluate the impact of continuity of care combined with immunomodulatory nutrition on the postoperative recovery and quality of life of patients undergoing PD surgery.
Methods: This was a randomized controlled study involving 120 patients who underwent PD surgery at our hospital between February 2022 and February 2024. The patients were randomly divided into the conventional care group (CG) and the intervention group (IG), with the latter receiving continuity of care combined with arginine-rich immunonutritional support. The main observation indicators included survival analysis, recovery of gastrointestinal function, length of hospital stay, nutritional status, immune function, postoperative complications, negative emotions and quality of life.
Results: There was no significant difference in the overall survival rate between the two groups. Compared with the CG, the IG had shorter length of hospital stay, better recovery of gastrointestinal function, better improvements of nutritional indicators such as ALB and PAB, lower levels of pro-inflammatory factors TNF-α, IL-6 and CRP, better improvement of CD4+/CD8+ ratio, lower incidence of postoperative complications, lower SAS and SDS scores and better quality of life.
Conclusion: Continuity of care combined with immunomodulatory nutrition provides a strong rationale for postoperative care of PD, and is worthy of clinical promotion and practice. More clinical cases and long-term follow-ups are needed to further verify its effectiveness.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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