Effect of rapid rehabilitation management measures by multidisciplinary cooperation onhospital stay and complications after liver transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WAN Juan ¹ ,  TANG Li ² , REN Qiuping ¹ , WU Menghang ¹ , YAN Lünan ³ , YANG Jiayin ³ , JIANG Li ³

1. Department of Liver Surgery, West China Hospital of Sichuan University / West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;
3. Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

TANG Li, Email: 7767169262@qq.com

Keywords：

Liver transplantation; multidisciplinary cooperation; rapid rehabilitation; complication

DOI：

10.7507/1007-9424.202105076

Video：

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Objective To explore effect of rapid rehabilitation management measures by multidisciplinary cooperation on hospital stay and complications after liver transplantation. Methods The convenience sampling method was used to collect the liver transplant patients in the Department of Liver Surgery of West China Hospital of Sichuan University. The patients underwent the rapid rehabilitation management measures by multidisciplinary cooperation from January 2017 to December 2017 as the study group and the patients underwent the routine management measures from January 2015 to December 2016 as the control group. The postoperative intensive care unit (ICU) stay time and postoperative hospitalization time were recorded and the postoperative complications were observed. Results A total of 175 patients with liver transplantation were included, including 78 cases in the study group and 97 cases in the control group. There were no significant differences in the age, gender, hemoglobin, leukocyte count, platelet count, total bilirubin, aspartate aminotransferase, alanine aminotransferase, albumin, prothrombin time, acute liver failure, model for end-stage liver disease score, liver transplantation mode, operation time, and intraoperative bleeding between the two groups (P>0.05). The postoperative ICU stay time and postoperative hospitalization time were shorter and the incidences of total postoperative complications and gade of complications were lower in the study group as compared with the control group (P<0.05). Conclusion From preliminary results of this study, rapid rehabilitation management measures by multidisciplinary cooperation could shorten postoperative ICU stay time and postoperative hospitalization time, reduce incidence of postoperative complications, and be more conducive to postoperative rehabilitation.

Citation： WAN Juan, TANG Li, REN Qiuping, WU Menghang, YAN Lünan, YANG Jiayin, JIANG Li. Effect of rapid rehabilitation management measures by multidisciplinary cooperation onhospital stay and complications after liver transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(3): 315-321. doi: 10.7507/1007-9424.202105076 Copy

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2.	Trotter JF. Liver transplantation around the world. Curr Opin Organ Transplant, 2017, 22(2): 123-127.
3.	范燁, 壯麟, 魯皓, 等. 快速康復外科治療在肝移植中的應用價值. 器官移植, 2014, 5(6): 348-351, 376.
4.	李妍. 快速康復外科理念在肝移植手術護理中的應用效果. 現代醫學與健康研究(電子版), 2019, 3(4): 109-111.
5.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
6.	Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med, 2009, 360(5): 491-499.
7.	Pillai SA, Palaniappan R, Pichaimuthu A, et al. Feasibility of implementing fast-track surgery in pancreaticoduodenectomy with pancreaticogastrostomy for reconstruction—a prospective cohort study with historical control. Int J Surg, 2014, 12(9): 1005-1009.
8.	Lin DX, Li X, Ye QW, et al. Implementation of a fast-track clinical pathway decreases postoperative length of stay and hospital charges for liver resection. Cell Biochem Biophys, 2011, 61(2): 413-419.
9.	蔡明, 胡紫宜, 張琨, 等. 甲狀腺癌術后患者隨訪需求調查及影響因素分析. 中國普外基礎與臨床雜志, 2021, 28(9): 1193-1199.
10.	孫靜, 楊揚, 李丹丹, 等. 快速康復外科聯合身心干預對全髖關節置換術患者術后恢復及心理的影響. 護理實踐與研究, 2021, 18(9): 1357-1360.
11.	付永惠, 管雪靜, 鄧志宏. 個性心理干預對肺癌手術患者術前焦慮與術后恢復的影響. 智慧健康, 2020, 6(30): 87-88, 95.
12.	Wan X, Bi J, Gao X, et al. Partial enteral nutrition preserves elements of gut barrier function, including innate immunity, intestinal alkaline phosphatase (IAP) level, and intestinal microbiota in mice. Nutrients, 2015, 7(8): 6294-6312.
13.	Oshodi TO. Clinical skills: an evidence-based approach to preoperative fasting. Br J Nurs, 2004, 13(16): 958-962.
14.	Crenshaw JT, Winslow EH. Preoperative fasting: old habits die hard. Am J Nurs, 2002, 102(5): 36-44.
15.	Noba L, Wakefield A. Are carbohydrate drinks more effective than preoperative fasting: a systematic review of randomised controlled trials. J Clin Nurs, 2019, 28(17-18): 3096-3116.
16.	胡艷杰, 羅艷麗, 李卡, 等. 肝切除術圍術期避免使用胃腸減壓的安全性和可行性探討. 重慶醫學, 2018, 47(33): 4299-4301, 4306.
17.	Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med, 1996, 334(19): 1209-1215.
18.	Lenhardt R, Marker E, Goll V, et al. Mild intraoperative hypothermia prolongs postanesthetic recovery. Anesthesiology, 1997, 87(6): 1318-1323.
19.	盧小麗, 廖燕, 唐艷燕. 肝移植術后患者ICU期間每日核查表的設計與應用. 中華現代護理雜志, 2013, 48(35): 4418-4421.
20.	王瓊. 肝移植后彩色多普勒超聲的應用. 中國組織工程研究與臨床康復, 2011, 15(31): 5846-5849.
21.	吳倩倩, 冀海斌, 方秀新, 等. 術后早期活動對腹部手術病人快速康復影響的Meta分析. 循證護理, 2020, 6(3): 205-211.
22.	Kishi Y, Abdalla EK, Chun YS, et al. Three hundred and one consecutive extended right hepatectomies: evaluation of outcome based on systematic liver volumetry. Ann Surg, 2009, 250(4): 540-548.
23.	Gotthardt DN, Bruns H, Weiss KH, et al. Current strategies for immunosuppression following liver transplantation. Langenbecks Arch Surg, 2014, 399(8): 981-988.
24.	Asrani SK, Kamath PS. Model for end-stage liver disease score and MELD exceptions: 15 years later. Hepatol Int, 2015, 9(3): 346-354.

1. Olivo R, Guarrera JV, Pyrsopoulos NT. Liver transplantation for acute liver failure. Clin Liver Dis, 2018, 22(2): 409-417.
2. Trotter JF. Liver transplantation around the world. Curr Opin Organ Transplant, 2017, 22(2): 123-127.
3. 范燁, 壯麟, 魯皓, 等. 快速康復外科治療在肝移植中的應用價值. 器官移植, 2014, 5(6): 348-351, 376.
4. 李妍. 快速康復外科理念在肝移植手術護理中的應用效果. 現代醫學與健康研究(電子版), 2019, 3(4): 109-111.
5. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
6. Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med, 2009, 360(5): 491-499.
7. Pillai SA, Palaniappan R, Pichaimuthu A, et al. Feasibility of implementing fast-track surgery in pancreaticoduodenectomy with pancreaticogastrostomy for reconstruction—a prospective cohort study with historical control. Int J Surg, 2014, 12(9): 1005-1009.
8. Lin DX, Li X, Ye QW, et al. Implementation of a fast-track clinical pathway decreases postoperative length of stay and hospital charges for liver resection. Cell Biochem Biophys, 2011, 61(2): 413-419.
9. 蔡明, 胡紫宜, 張琨, 等. 甲狀腺癌術后患者隨訪需求調查及影響因素分析. 中國普外基礎與臨床雜志, 2021, 28(9): 1193-1199.
10. 孫靜, 楊揚, 李丹丹, 等. 快速康復外科聯合身心干預對全髖關節置換術患者術后恢復及心理的影響. 護理實踐與研究, 2021, 18(9): 1357-1360.
11. 付永惠, 管雪靜, 鄧志宏. 個性心理干預對肺癌手術患者術前焦慮與術后恢復的影響. 智慧健康, 2020, 6(30): 87-88, 95.
12. Wan X, Bi J, Gao X, et al. Partial enteral nutrition preserves elements of gut barrier function, including innate immunity, intestinal alkaline phosphatase (IAP) level, and intestinal microbiota in mice. Nutrients, 2015, 7(8): 6294-6312.
13. Oshodi TO. Clinical skills: an evidence-based approach to preoperative fasting. Br J Nurs, 2004, 13(16): 958-962.
14. Crenshaw JT, Winslow EH. Preoperative fasting: old habits die hard. Am J Nurs, 2002, 102(5): 36-44.
15. Noba L, Wakefield A. Are carbohydrate drinks more effective than preoperative fasting: a systematic review of randomised controlled trials. J Clin Nurs, 2019, 28(17-18): 3096-3116.
16. 胡艷杰, 羅艷麗, 李卡, 等. 肝切除術圍術期避免使用胃腸減壓的安全性和可行性探討. 重慶醫學, 2018, 47(33): 4299-4301, 4306.
17. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med, 1996, 334(19): 1209-1215.
18. Lenhardt R, Marker E, Goll V, et al. Mild intraoperative hypothermia prolongs postanesthetic recovery. Anesthesiology, 1997, 87(6): 1318-1323.
19. 盧小麗, 廖燕, 唐艷燕. 肝移植術后患者ICU期間每日核查表的設計與應用. 中華現代護理雜志, 2013, 48(35): 4418-4421.
20. 王瓊. 肝移植后彩色多普勒超聲的應用. 中國組織工程研究與臨床康復, 2011, 15(31): 5846-5849.
21. 吳倩倩, 冀海斌, 方秀新, 等. 術后早期活動對腹部手術病人快速康復影響的Meta分析. 循證護理, 2020, 6(3): 205-211.
22. Kishi Y, Abdalla EK, Chun YS, et al. Three hundred and one consecutive extended right hepatectomies: evaluation of outcome based on systematic liver volumetry. Ann Surg, 2009, 250(4): 540-548.
23. Gotthardt DN, Bruns H, Weiss KH, et al. Current strategies for immunosuppression following liver transplantation. Langenbecks Arch Surg, 2014, 399(8): 981-988.
24. Asrani SK, Kamath PS. Model for end-stage liver disease score and MELD exceptions: 15 years later. Hepatol Int, 2015, 9(3): 346-354.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of rapid rehabilitation management measures by multidisciplinary cooperation onhospital stay and complications after liver transplantation

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