Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 4983-4991
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.4983
Enhanced recovery after surgery-based nursing in older patients with postoperative intestinal obstruction after gastric cancer surgery: A retrospective study
Yu-Qin Li, Ying Liu, Zhu-Qing Peng, Rong Fang, Hai-Yan Xu
Yu-Qin Li, Zhu-Qing Peng, Rong Fang, Hai-Yan Xu, Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan 430033, Hubei Province, China
Ying Liu, Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei Province, China
Co-first authors: Yu-Qin Li and Ying Liu.
Author contributions: Li YQ and Liu Y designed the study and wrote the first draft; Peng ZQ collected and analysed the data and reworked the manuscript; Fang R completed the typesetting of the article; Xu HY supervised the whole process; all authors reviewed the manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Wuhan Fourth Hospital (No. KY2022-037-01).
Informed consent statement: Due to the nature of this study, the data used in the study did not involve in the patients’ privacy information, and all patient data obtained, recorded, and managed were only used for this study, without any harm to the patient. Obtaining informed consent from study participants is not feasible. This decision has been reviewed and approved by the Institutional Review Board of Wuhan Fourth Hospital.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
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: Hai-Yan Xu, BMed, Chief Nurse, Department of Gastroenterology, Wuhan Fourth Hospital, No. 473 Hanzheng Street, Qiaokou District, Wuhan 430033, Hubei Province, China. xu24323@163.com
Received: April 7, 2024
Revised: May 19, 2024
Accepted: May 28, 2024
Published online: August 6, 2024
Processing time: 85 Days and 19.2 Hours
Abstract
BACKGROUND

Gastric cancer-related morbidity and mortality rates are high in China. Patients who have undergone gastric cancer surgery should receive six cycles of chemotherapy according to their condition. During this period, intestinal obstruction is likely to occur. Electrolyte balance disorders, peritonitis, intestinal necrosis, and even hypovolemic shock and septic shock can seriously affect the physical and mental recovery of patients and threaten their health and quality of life (QoL).

AIM

To quantitatively explore the effects of enhanced recovery after surgery (ERAS)–based nursing on anxiety, depression, and QoL of elderly patients with postoperative intestinal obstruction after gastric cancer.

METHODS

The clinical data of 129 older patients with intestinal obstruction after gastric cancer surgery who were treated and cared for in our hospital between January 2019 and December 2021 were examined retrospectively. Nine patients dropped out because of transfer, relocation, or death. According to the order of admissions, the patients were categorized into either a comparison group or an observation group according to the random number table, with 60 cases in each group.

RESULTS

After nursing care, the observation group required significantly less time to eat for the first time, recover bowel sounds, pass gas, and defecate than the comparison group (P < 0.05). No significant difference was noted in nutrition-related indicators between the two groups before care. Before care, the Symptom Check List-90 scores between the two groups were comparable, whereas anxiety, depression, paranoia, fear, hostility, obsession, somatization, interpersonal sensitivity, and psychotic scores were significantly lower in the observation group after care (P < 0.05). The QoL scores between the two groups before care did not differ significantly. After care, the physical, social, physiological, and emotional function scores; mental health score; vitality score; and general health score were significantly higher in the observation group, whereas the somatic pain score was significantly lower in the observation group (P < 0.05).

CONCLUSION

ERAS-based nursing combined with conventional nursing interventions can effectively improve patient’s QoL, negative emotions, and nutritional status; accelerate the time to first ventilation; and promote intestinal function recovery in elderly patients with postoperative intestinal obstruction after gastric cancer surgery.

Keywords: Gastric cancer; Enhanced recovery after surgery–based nursing; Gastrointestinal function; Quality of life; Nutritional status

Core Tip: This study revealed that enhanced recovery after surgery (ERAS)-based nursing significantly improved gastrointestinal function, reduced adverse emotional states, and enhanced quality of life in elderly patients with postoperative intestinal obstruction following gastric cancer surgery. By integrating ERAS with traditional nursing interventions, patients experienced faster recovery of essential functions like eating and bowel movement, alongside notable improvements in nutritional status and psychological well-being. These findings underscore the effectiveness of ERAS in fostering a holistic recovery, suggesting its potential as a standard care component for postoperative management in this patient population.