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Perioperative Medicine in Pancreatic Surgery
1.
Thank you for your willingness to participate in this cross-sectional study on the implementation and adherence to ERAS concepts in pancreatic surgery.
Please refer to the attached participant information sheet and consent form for detailed information on the purpose, procedures, data protection, and your rights as a study participant.
The following survey is conducted using the online tool SurveyMonkey, is anonymous, and takes approximately 10–15 minutes to complete. Participation is voluntary and you may discontinue at any time without providing a reason.
Have you read the participant information and consent form, and do you agree to voluntarily participate in this anonymous online survey?
Yes, I agree and wish to participate.
No, I do not wish to participate.
2.
Does your hospital have a standardized FAST track / ERAS treatment concept with required perioperative measures for pancreatic surgery?
Yes, supported by the ERAS-Society
Yes, supported by the industry
Yes, without support
No
Other (please specify)
3.
If your hospital has an interdisciplinary Fast Track / ERAS team, which disciplines are represented in this team? (Multiple selection possible)
Surgery
Anesthesia
Nurse specialized in Fast-Track / ERAS
Nutritional medicine /nutritional counselling
Physiotherapy
Psycho-oncology/ Psychological care
There is no interdisciplinary team
Other (please specify)
4.
Does your hospital have an SOP (Standard Operating Procedure) or comparable for the perioperative treatment of patients undergoing pancreatic resections?
Yes
No
Other (please specify)
5.
Does your hospital perform regular audits (compliance checks) of the ERAS protocol for pancreatic surgery?
Yes, regular audit with feedback based on an electronic database
Yes, internal audit without electronic database/formal feedback loop
No
6.
Are your patients specifically informed about the perioperative treatment concept for pancreatic surgery as part of the outpatient preparation? (Multiple selection possible)
Yes, as part of the surgical risk education
Yes, by specialized nursing staff
Yes, in the form of a patient brochure / information video etc.
No
Other (please specify)
7.
For which of the following preoperative measures do you offer your patients support, e.g. in the form of advice, training or prescription? (Multiple selection possible)
Nicotine abstinence
Alcohol abstinence
Increasing physical activity
Optimization of nutrition / Prevention of severe malnutrition
Psycho(onco)logical care
Other (please specify)
8.
Is routine preoperative biliary drainage performed?
Yes
No
Only if decompression is needed (bilirubin level above 250 µmol/L and/or preoperative
9.
Is routine preoperative oral immunonutrition used?
Yes
No
10.
Is antithrombotic prophylaxis-initiated pre-incision and extended postoperatively?
Yes, prophylaxis is started 2-12 hours before surgery
Yes, prophylaxis is extended to 4 weeks postoperatively
Other (please specify)
11.
What is the practice regarding preanesthetic medication?
Non-opioids
Opioids
Anxiolytics
Other (please specify)
12.
How are prophylactic antibiotics managed? (Multiple selection possible)
Single-dose intravenous antibiotics are administered within 60 minutes before skin incision
Repeated intraoperative doses are administered depending on the half-life of the drug
Use of postoperative prophylactic antibiotics
Other (please specify)
13.
Which surgical procedure is predominantly used at your clinic for pancreatic resections?
Robotic resection
Laparoscopic surgery
Open surgery
Other (please specify)
14.
What is the goal for intraoperative fluid balance?
Restrictive fluid management is targeted, using goal-directed fluid therapy
Liberal fluid administration is preferred
Fluid administration based on central venous pressure/urine output only
Other (please specify)
15.
What is the standard for postoperative nausea and vomiting (PONV) prophylaxis?
All patients receive PONV prophylaxis
Combination of two or three antiemetics for high-risk patients (two or more risk factors)
Other (please specify)
16.
Which measures for post-operative pain therapy are mainly used in open pancreatic surgery at your clinic?
Epidural analgesia via PDK
TAP block
Local infiltration of the surgical access
Analgesic pump / Patient controlled analgesia
Short infusions / Oral administration of opioids
Analgesia using only non-opioid analgesics
17.
Which measures for post-operative pain therapy are mainly used in minimally invasive pancreatic surgery at your clinic?
Epidural analgesia via PDK
TAP block
Local infiltration of the surgical access
Analgesic pump / Patient controlled analgesia
Short infusions / Oral administration of opioids
Analgesia using only non-opioid analgesics
18.
When is the postoperative removal of the urinary catheter pancreatic surgery usually performed?
Postoperatively in the operating room
On the first postoperative day
On the 2nd-5th postoperative day
After mobilization is completed
Other (please specify)
19.
When is the postoperative removal of the nasogastric tube pancreatic surgery usually performed?
Postoperatively in the operating room
On the first postoperative day
On the 2nd-5th postoperative day
After mobilization is completed
Other (please specify)
20.
When is the postoperative removal of the abdominal drains pancreatic surgery usually performed?
No drains are inserted routinely
On the first postoperative day, if drain amylase is low
Kept until output volume is minimal
Other (please specify)
21.
When is the postoperative removal of the central lines pancreatic surgery usually performed?
It is not used regularly
On the first postoperative day
On the 2nd-5th postoperative day
Other (please specify)
22.
Are Somatostatin analogues used for fistula prophylaxis?
Yes
No
23.
Which of the following is the standard practice for postoperative glycemic control?
Blood glucose levels are maintained close to normal but without aiming for strict glycemic control
Strict glycemic control is maintained
No specific protocol for perioperative glycemic control
Other (please specify)
24.
What is the protocol for postoperative oral feeding?
Normal diet (solid food) is started on the first postoperative day
Clear liquids are started on the first postoperative day, advancing slowly
Feeding is delayed until return of bowel function (3rd postoperative day or later)
Other (please specify)
25.
How is the recovery of bowel function managed? (Multiple selection possible)
Chewing gum is routinely used for stimulation
µ-opioid receptor antagonists
Prokinetics
Other (please specify)
26.
How is the risk of delayed gastric emptying mainly managed?
Timely diagnosis and management of intra-abdominal complications
Administration of artificial nutrition
Use of prokinetics
Other (please specify)
27.
When is mobilization started?
Active and scheduled mobilization begins on the day of surgery
Mobilization begins on postoperative day 1
Mobilization is delayed until catheters are removed
Other (please specify)
28.
What is the average postoperative hospital stay at your hospital?
1 - 3 days
4 - 6 days
7 - 9 days
10 -12 days
13 - 15 days
16 - 18 days
19 days or longer
29.
How would you describe the cooperation regarding perioperative management with the anaesthesiological partner?
Very good
Good
Satisfactory
Adequate
Poor
Insufficient
30.
How old are you?
30 years or younger
31-40 years
41-50 years
51-60 years
61-70 years
Older than 70 years
31.
What is your professional position?
Resident
Senior physician
Leading Senior Physician
Chief of Surgery
General practitioner
Other (please specify)
32.
Where are you currently working?
University Hospital
Tertiary care hospital
Secondary care hospital
Primary care hospital
Individual practice / group practice / joint practice
MVZ
Other (please specify)
33.
Your comments on this survey
Thank you very much for your valuable contribution to this study.