Designing guidelines for perioperative care (before, during and after surgery) of esophagectomy to increase the stability of the hemodynamic status and reduce the length of stay in the ICU

Abstract

The perioperative status of patients, encompassing preoperative, intraoperative, and postoperative phases, significantly influences the effective management of these individuals during surgery and their stay in the intensive care unit (ICU). Failure to adequately address these phases can lead to adverse outcomes, including increased mortality rates. Despite various studies examining the care protocols for patients undergoing esophagectomy during these three critical phases, there has yet to be a comprehensive synthesis of these efforts. Consequently, a holistic approach to perioperative care has not been established. This study aims to design a guideline for perioperative care in esophagectomy patients, focusing on enhancing hemodynamic stability and reducing ICU length of stay. Methods: This research is a methodological study of psychometric analysis, conducted descriptively and analytically after obtaining ethical approval from the Ethics Committee of Tabriz University of Medical Sciences. A comprehensive literature search was conducted from 1995 to 2023, encompassing all studies that addressed preoperative, intraoperative, and postoperative care in esophagectomy patients. The focus was on methodologies that reported on interventions leading to improved hemodynamic status and reduced hospital stays. The Delphi method was employed to finalize the guidelines based on expert consensus. Findings: The findings of this study underscore the critical importance of adhering to perioperative care protocols in enhancing the quality of medical care and minimizing surgical complications. The investigations revealed that implementing appropriate protocols at each surgical phase, particularly in monitoring vital signs, managing pain, and caring for surgical wounds, significantly impacts patient outcomes. Furthermore, addressing psychological and nutritional aspects also contributes to recovery and helps prevent potential complications. Overall, these results highlight the necessity of meticulous attention to surgical details and effective collaboration among the healthcare team.