Results of a National Survey About Perioperative Care in Gastric Resection Surgery

• Published in: Cirugia española (English ed.) 2018-08, Vol.96 (7), p.410-418
• Main Authors: Bruna, Marcos, Navarro, Carla, Báez, Celia, Ramírez, José Manuel, Ortiz, María Ángeles
• Format: Article
• Language: English
• Subjects: Cirugía gástrica; Encuesta; Enhanced recovery after surgery; Female; Gastrectomy; Gastric surgery; General Surgery; Health Care Surveys; Humans; Male; Middle Aged; Perioperative Care - methods; Practice Patterns, Physicians; Rehabilitación multimodal; Spain; Survey
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2018.07.010

Enhanced recovery after surgery programs in abdominal surgery are being established progressively. The aim of this study is to evaluate the application of different perioperative care measures in gastric surgery by Spanish surgeons. A descriptive study of 162 surveys answered from September to December 2017 about the management and perioperative care in non-bariatric gastric resection surgery. Antibiotic and antithrombotic prophylaxis are always used by 96.9 and 99.4%, respectively; 62.7% recommend a fasting time for liquids >6h and only 3% use preoperative carbohydrate drinks. Only 32.4 and 13.3% of subtotal and total gastrectomies are performed laparoscopically, respectively; 56.8% use epidural analgesia, and drains are always placed by 53.8% in total gastrectomy. Nasogastric tubes are used selectively by 34.6% and always by 11.3%. Bladder catheters are removed during the first 48h by 77.2%. In the first 24 postoperative hours, less than 20% indicate oral intake and 15.4% mobilize their patients; 49.3% indicate walking after the first 24h; 30.4% apply a clinical pathway for the care of these patients and only 15.2% used an enhanced recovery after surgery protocol. The implementation of enhanced recovery after surgery measures in non-bariatric gastric resection surgery is not widespread in our country. Las medidas de rehabilitación multimodal en cirugía abdominal se están instaurando progresivamente. El objetivo del estudio es evaluar la aplicación de diferentes cuidados perioperatorios en la cirugía gástrica por parte de los cirujanos españoles. Estudio descriptivo de 162 encuestas contestadas desde septiembre a diciembre de 2017 acerca del manejo y cuidados perioperatorios en cirugía de resección gástrica no bariátrica. Las profilaxis antibiótica y antitrombótica son empleadas siempre por el 96,9 y 99,4%, respectivamente. El tiempo de ayuno para líquidos es mayor de 6horas para el 62,7%, empleando solo bebidas con sobrecarga de hidratos de carbono prequirúrgicamente el 3%. Tan solo el 32,4 y el 13,3% de las gastrectomías subtotales y totales son realizadas laparoscópicamente. El 56,8% emplea analgesia epidural y los drenajes son colocados siempre por un 53,8% en la gastrectomía total. La sonda nasogástrica es empleada selectivamente por el 34,6% y siempre por el 11,3%. La retirada del catéter vesical es realizada durante las primeras 48horas por el 77,2%. En las primeras 24horas postoperatorias, menos del 20% indica la ingesta oral y un 15,4% moviliza a