Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2024; 12(20): 4034-4040
Published online Jul 16, 2024. doi: 10.12998/wjcc.v12.i20.4034
Effects of integrated management on surgical outcomes and mental health of patients following endoscopic submucosal dissection
Zhu-Hua Dai, Lu Xu, Yu Yang, Xu-Ni He, Ke Chen
Zhu-Hua Dai, Lu Xu, Yu Yang, Xu-Ni He, Ke Chen, Department of Gastroenterology, Ningbo Yinzhou No. 2 Hospital, Ningbo 315000, Zhejiang Province, China
Author contributions: Dai ZH conceived the study and wrote the first draft of the manuscript; Xu L and Yang Y contributed to methodology and data collection; He XN was responsible for data analysis and visualization; Chen K completed manuscript revisions.
Institutional review board statement: The study was approved by the Ethics Committee of Ningbo Yinzhou No. 2 Hospital (No. ZXIRB2022301).
Informed consent statement: The patients agreed to participate in this study and were asked to sign an informed consent form prior to enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ke Chen, MD, Doctor, Department of Gastroenterology, Ningbo Yinzhou No. 2 Hospital, No. 998 Qianhe Road, Yinzhou District, Ningbo 315000, Zhejiang Province, China. 13429322668@163.com
Received: March 14, 2024
Revised: April 30, 2024
Accepted: May 20, 2024
Published online: July 16, 2024
Processing time: 107 Days and 12.8 Hours
Abstract
BACKGROUND

Endoscopic submucosal dissection (ESD) is a less invasive local treatment for diseases throughout the gastrointestinal tract.

AIM

To develop an integrated management protocol and analyze its effects on surgical outcomes and mental health of patients after ESD.

METHODS

The study population consisted of patients undergoing ESD before implementation of integrated management and those undergoing ESD by the same pool of surgeons after implementation of integrated management.

RESULTS

The management group exhibited shortened fasting time and length of hospital stay compared to the control group (P < 0.05). The management group exhibited a higher incidence rate of postoperative complications than the control group (3 cases vs 11 cases; P = 0.043). The management group exhibited a lower uncertainty score for disease knowledge compared to the control group 12 h after surgery (P < 0.05). The management group gave more scores on the domains of patient familiarity to the responsible nurses, professional skills of responsible nurses, and general evaluation compared to the control group. The management group had a higher total score of patient satisfaction towards the responsible nurses in term of health care than the control group (P < 0.01). The management group exhibited lower Self-Rating Anxiety Scale and Self-Rating Depression Scale scores compared to the control group 12 h after surgery (P < 0.01).

CONCLUSION

The study demonstrates that integrated management could improve surgical outcomes and mental health of patients undergoing ESD.

Keywords: Endoscopic submucosal dissection, Gastrointestinal tract, Hospital stay, Outcome, Mental health

Core Tip: Technical difficulty results in a long time as well as many postoperative complications in the process of implementing endoscopic submucosal dissection (ESD). The integrated management protocol involving a multidisciplinary team, ESD guidelines and nursing pathway, health education model, and discharge criteria could improve surgical outcomes and mental health of patients undergoing ESD.