Emergent Surgery, Perforated Peptic Ulcer
Conditions
Brief summary
This study aimed to evaluate the effect of implementing post operative enhanced recovery on perforated peptic ulcer surgery outcome. The current study anticipated better outcomes in the form of early functional recovery, reduced length of hospital stays, less thirty days post operative morbidity, and better gastrointestinal quality of life after implementing post operative enhanced recovery in patients with perforated peptic ulcer.
Detailed description
This study aimed to evaluate the effect of implementing post operative enhanced recovery on perforated peptic ulcer surgery outcomes. Methods: Quasi- experimental research design was utilized. The study was conducted at Assiut University Hospital. A purposive sample of thirty patients (study group) who received postoperative enhanced recovery after open surgical repair of perforated peptic ulcer compared with thirty patients (control group) who exposed to routine care. patient assessment sheet and gastrointestinal quality of life index were the tools used for data collection.
Interventions
PROCEDUREPost operative enhanced recovery elements
According to the study group the researchers collaborated with surgeons, nurses, and anesthesiologists to implement post operative enhanced recovery protocol that defined clearly in the following elements Early nutrition, Early mobilization, Non-opioid analgesia. Early removal of abdominal drains and tubes throughout the patients' hospital stay up to their discharge.
Sponsors
Assiut University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age ranged from 18 to 65 years, * Diagnosed with perforated peptic ulcer, * Ulcer size less than 10 mm. * Underwent emergent surgical intervention
Exclusion criteria
* Malignant ulcer. * Other GIT diseases (corn's disease & ulcerative colitis) * Pregnant women * Psychiatric or neurological illness. * Who refused to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gastrointestinal functional recovery (first bowel movement) | Within the first 24 hours postoperative or more | Tool; Patient assessment sheet * It was developed by researchers based on literatures review to assess postoperative clinical data (part 2) as gastrointestinal functional recovery (first bowel movement) through physical examination. * The mean score of time for two groups was compared |
| Gastrointestinal functional recovery(first flatus passage) | Within the first 24 hours postoperative or more | Tool; Patient assessment sheet * It was developed by researchers based on literatures review to assess postoperative clinical data (part 2) as gastrointestinal functional recovery (first flatus passage) through physical examination. the mean score of time for two groups was compared |
| Gastrointestinal functional recovery(first stool passage) | First stool passage within three days postoperative or more | Tool; Patient assessment sheet \- It was developed by researchers based on literatures review to assess postoperative clinical data (part 2) as gastrointestinal functional recovery (first stool passage) postoperative.through health history. The mean score of time for two groups was compared |
| postoperative complications | Immediately post operative up to thirty days postoperative | post operative complications included complications that occured within 30- days post operative. Every patient had been assessed for developing pneumonia, admission to critical care, abdominal collection, intra-abdominal abscess, suture leakage, omental patch leakage, septic shock, prolonged ileus, surgical site infection, urinary tract infection, deep venous thrombosis (DVT), and reoperation |
| Legnth of hospital stay | seven days up to two weeks | Hospitalization duration from admission up to discharge Mean score of days for two groups will be compared. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| gastrointestinal quality of life | Before hospital dicharge and after thirty days postoperative | gastrointestinal quality of life was evaluated for all patients before discharge and after thirty days postoperative using Gastrointestinal quality of life index (Eypasch, 1993). It is a 36-item scale divided into five domains; GIT symptoms (10 items), physical (6 items), emotion (6 items), social (2 items) and disease specific (8 items) Cronbach's alpha was 0.89 Scoring: Each item is based on a 0-4 Likert scale with 0 being least desirable to 4 being the most desirable option. The total scores represent Gastrointestinal Quality of Life Index. It ranges from 0 to 144 with higher scores indicating a better quality of life |
Countries
Egypt
Outcome results
None listed