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

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.	范烨, 壮麟, 鲁皓, 等. 快速康复外科治疗在肝移植中的应用价值. 器官移植, 2014, 5(6): 348-351, 376.
4.	李妍. 快速康复外科理念在肝移植手术护理中的应用效果. 现代医学与健康研究(电子版), 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, 张琨, 等. 甲状腺癌术后患者随访需求调查及影响因素分析. 中国普外基础与临床杂志, 2021, 28(9): 1193-1199.
10.	孙静, 杨扬, 李丹丹, 等. 快速康复外科联合身心干预对全髋关节置换术患者术后恢复及心理的影响. 护理实践与研究, 2021, 18(9): 1357-1360.
11.	付永惠, 管雪静, 邓志宏. 个性心理干预对肺癌手术患者术前焦虑与术后恢复的影响. 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.	胡艳杰, 罗艳丽, 李卡, 等. 肝切除术围术期避免使用胃肠减压的安全性和可行性探讨. 重庆医学, 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.	卢小丽, 廖燕, 唐艳燕. 肝移植术后患者ICU期间每日核查表的设计与应用. 中华现代护理杂志, 2013, 48(35): 4418-4421.
20.	王琼. 肝移植后彩色多普勒超声的应用. 中国组织工程研究与临床康复, 2011, 15(31): 5846-5849.
21.	吴倩倩, 冀海斌, 方秀新, 等. 术后早期活动对腹部手术病人快速康复影响的Meta分析. 循证护理, 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. 范烨, 壮麟, 鲁皓, 等. 快速康复外科治疗在肝移植中的应用价值. 器官移植, 2014, 5(6): 348-351, 376.
4. 李妍. 快速康复外科理念在肝移植手术护理中的应用效果. 现代医学与健康研究(电子版), 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, 张琨, 等. 甲状腺癌术后患者随访需求调查及影响因素分析. 中国普外基础与临床杂志, 2021, 28(9): 1193-1199.
10. 孙静, 杨扬, 李丹丹, 等. 快速康复外科联合身心干预对全髋关节置换术患者术后恢复及心理的影响. 护理实践与研究, 2021, 18(9): 1357-1360.
11. 付永惠, 管雪静, 邓志宏. 个性心理干预对肺癌手术患者术前焦虑与术后恢复的影响. 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. 胡艳杰, 罗艳丽, 李卡, 等. 肝切除术围术期避免使用胃肠减压的安全性和可行性探讨. 重庆医学, 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. 卢小丽, 廖燕, 唐艳燕. 肝移植术后患者ICU期间每日核查表的设计与应用. 中华现代护理杂志, 2013, 48(35): 4418-4421.
20. 王琼. 肝移植后彩色多普勒超声的应用. 中国组织工程研究与临床康复, 2011, 15(31): 5846-5849.
21. 吴倩倩, 冀海斌, 方秀新, 等. 术后早期活动对腹部手术病人快速康复影响的Meta分析. 循证护理, 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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