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Hospital Perioperative Management for Liver Surgery
1.
Thank you for your willingness to participate in this cross-sectional study on the implementation and adherence to ERAS concepts in liver 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 liver?
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? Select all that apply.
Surgery
Anaesthesia
Nurse specialised in Fast-Track / ERAS
Nutritional medicine / nutritional counselling
Physiotherapy
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 liver resections?
Yes
No
Other (please specify)
5.
Are your patients specifically informed about the perioperative treatment concept for liver surgery as part of the outpatient preparation? Select all that apply.
Yes, as part of the surgical risk education
Yes, by specialised nursing staff
Yes, in the form of a patient brochure / information video etc
No
Other (please specify)
6.
For which of the following preoperative measures do you offer your patients support, e.g., in the form of advice, training or prescription? Select all that apply.
Nicotine abstinence
Alcohol abstinence
Increasing physical activity
Optimisation of food intake / prevention of malnutrition
Psycho(onco)logical care
Other (please specify)
7.
Do your patients receive preoperative biliary drainage before liver surgery?
Only major resection (≥ 3 segments)
Any elective liver resections
No
Other (please specify)
8.
If yes, which method of biliary drainage is performed in your clinic for liver resections?
PTCD (percutaneous transhepatic biliary drainage)
ERCP with bile duct stenting
EUS-guided biliary drainage
Other (please specify)
9.
What is the average preoperative fasting period of your patients before liver surgery?
Please enter the average number of hours between the last intake of solid food and the
operation
Please enter the average number of hours between drinking clear liquids and the operation
10.
Which surgical procedure is predominantly used for anatomical resections at your hospital?
Robotic resection
Laparoscopic surgery
Open surgery
Other (please specify)
11.
Which surgical procedure is predominantly used at your clinic for non-anatomical resections?
Robotic resection
Laparoscopic surgery
Open surgery
Other (please specify)
12.
Which measures for post-operative pain therapy are mainly used in open liver 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
13.
Which measures for post-operative pain therapy are mainly used in minimally invasive liver 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
14.
When is the postoperative removal of the urinary catheter after liver surgery usually performed?
Postoperatively in the operating room
On the first postoperative day
On the 2nd-5th postoperative day
After mobilisation is completed
Other (please specify)
15.
When is the postoperative removal of the gastric tube after liver surgery usually performed?
Postoperatively in the operating room
On the first postoperative day
On the 2nd-5th postoperative day
After mobilisation is completed
Other (please specify)
16.
When is the postoperative removal of the abdominal drains after liver surgery usually performed?
No drains are inserted
On the first postoperative day
Dependent on the amount of discharge
Other (please specify)
17.
When is the postoperative removal of the central lines after liver surgery usually performed?
It is not used regularly
On the first postoperative day
On the 2nd-5th postoperative day
Other (please specify)
18.
Please indicate on which postoperative day after liver surgery, given a normal postoperative course, the following measures are performed? (The day of surgery is day 0)
Mobilisation to the edge of the bed/ to a chair
Mobilisation to the ward corridor
Consumption of liquid food
Consumption of solid food
Termination of intravenous fluid substitutions
19.
Do your patients regularly receive a laxative postoperatively after liver surgery?
Yes, always on the first post-operative day
Yes, always on the second post-operative day
Yes, always on the third post-operative day
Yes, if there is no bowel movement within the first five postoperative days
No
Other (please specify)
20.
Are your patients monitored postoperatively in an intensive care unit in case of regular intraoperative course?
Only non-anatomical liver resections
Only anatomical resections
Only patients who have had open surgery
Yes, regardless of the operation performed
Not regularly
Other (please specify)
21.
What is the average post-operative hospital stay at your hospital? (Please select one of the following options from the drop-down menu)
1 - 3 days
4 - 6 days
7 - 9 days
10 -12 days
13 - 15 days
16 - 18 days
19 days or longer
22.
How would you describe the cooperation regarding perioperative management with the anaesthesiological partner?
Very good
Good
Satisfactory
Adequate
Poor
Insufficient
23.
How old are you?
30 years or younger
31-40 years
41-50 years
51-60 years
61-70 years
Older than 70 years
24.
What is your professional position?
Resident
Senior physician
Leading Senior Physician
Chief of Surgery
General practitioner
Other (please specify)
25.
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)
26.
Your comment on this survey
Thank you very much for your valuable contribution to this study.