Association of a standardized nursing protocol with postoperative complications following open radical gastrectomy: a...

Area of Science:

• Surgical Nursing
• Patient Outcomes
• Gastric Cancer Surgery

Background:

• Postoperative complications remain a significant concern following open radical gastrectomy for gastric cancer.
• Standardized nursing protocols may influence patient outcomes, but their independent association requires evaluation.

Purpose of the Study:

• To evaluate the independent association of a standardized, multi-modal intraoperative nursing protocol on postoperative complications in patients undergoing open radical gastrectomy for gastric cancer.

Main Methods:

• A retrospective cohort study included 89 patients undergoing open radical gastrectomy.
• Patients were divided into standardized (n=44) and non-standardized (n=45) care groups.
• Thirty-day complications (Clavien-Dindo ≥II) were the primary outcome, analyzed using multivariable logistic regression.

Main Results:

• The standardized care group had a significantly lower total complication rate (22.7% vs. 48.9%, p<0.01).
• Standardized nursing care was independently associated with reduced complications (adjusted OR=0.32; 95% CI: 0.12-0.85; p=0.022).
• Intraoperative hypothermia and operative time ≥200 min were independent risk factors.

Conclusions:

• A systematic intraoperative nursing protocol is significantly associated with reduced postoperative morbidity in open gastrectomy.
• This protocol helps mitigate risks such as hypothermia and prolonged operative time.
• Structured operating room nursing should be considered a core therapeutic intervention for improved surgical outcomes.