Hepatic Cancer, Cancer of Pancreas
Conditions
Keywords
fast track surgery, eras program, hepatectomy, pancreatectomy, NPY, ACTH/Cortsiosol, postoperative stress
Brief summary
A prospective randomized clinical study, with cross-sectional comparisons and correlations was conducted from May 2012 to July 2015 with a sample of 231 patients who have undergone hepatectomy or pancreatectomy, randomized into 2 groups. In group A was applied postoperatively the protocol Fast-track, while in group B the conventional postoperative care. Demographic and clinical data were collected. In 170 patients, Neuropeptide Y (NPY), Adrenocorticotropic hormone (ACTH)/Cortisol plasma levels were measured by ELISA method: a) at the day of patient's admission, b) the operation day, c) the 3rd postoperative day or prior to discharge.
Detailed description
Pain levels were assessed by Puntillo scale (behavioral observation scale) which has ranges; 0-1 no pain, 2-4 aching 5-7 moderate pain 8-10 and severe pain. Patient stress levels were evaluated by: a) scale I.C.U.E.S.S. which evaluated environmental stress during their stay in hospital and takes values; 40-80 no environmental stress 81-120 mild to moderate environmental stress, 121-160 Moderate to severe environmental stress , b) three questions of self- experienced feelings (with a score of 0 = None and 10 = Completely) like How sad you feel right now? How stress do you feel right now? How optimist do you feel right now about the future? The data collected in three phases: a) the day of hospitalization, b) the day of surgery, and c) the third postoperative day or before discharge. Depression levels were evaluated with Zung scale (Zung self-rating depression scale), which assesses depression levels with a score 25-49 for normal level mood, 50-59 for mild depression, 60-69 for moderate depression and 70 + for severe depression.
Interventions
PROCEDUREfast track protocol
Evaluation of postoperative stress
Sponsors
Saint Savvas Anticancer Hospital
National and Kapodistrian University of Athens
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
30 Years to 82 Years
Healthy volunteers
No
Inclusion criteria
* patients with American Society of Anesthesiologists (ASA) PHYSICAL STATUS CLASSIFICATION SYSTEM I-III * age 30-82 years, * with normal level of consciousness and communication
Exclusion criteria
* the presence of chronic pain, * kidney disease, neuropathy, * systemic as well as chronic treatment with analgesics
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Analyzing Neuropeptide Y, Cortisol and Adrenocorticotropic hormones levels in blood samples | Participants will be followed for the duration of hospital stay, an expected average of 15 days | Analyzing Neuropeptide Y, Cortisol and Adrenocorticotropic hormones levels in blood samples in patients after hepatectomy or pancreatectomy. These measures will occured in three phases a. the day of hospitalzation, b. the day of surgery c. the day of discharge. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluating postoporative stress between the two protocols with scales | Participants will be followed for the duration of hospital stay, an expected average of 15 days | Evaluating postoporative stress with scales, such as Zung scale the day of hospitalization, ICUESS scale the 3rd postoperative day, Puntillo scale the day of surgery and three self-experienced questions how sad are you feeling, how stressed are you feeling and how optimistic are you feeling in three phases:a. the day of hospitalzation, b. the day of surgery c. the day of discharge. |
| Evaluating postoperative pain between the two protocols with scale | Participants will be followed for the duration of hospital stay, an expected average of 15 days | Evaluating postoperative pain between the two protocols with scale such as Puntillo scale the day of surgery |
Outcome results
None listed