Optimising postoperative discharge plans for patients undergoing surgical treatment for gastric cancer: a literature review

Abstract

Background: Gastric (stomach) cancer is common, difficult to detect and has a high mortality rate. Many gastric cancers are treatable with invasive gastrointestinal surgery, including total or partial gastrectomy. These patients face many postoperative challenges, including pain, nausea and nutritional difficulties, as well as consequent anxiety and socio-economic challenges. Some healthcare institutions have implemented discharge plans as a cost-effective strategy to improve postoperative care. Aim: This systematic literature review aimed to identify essential elements to incorporate in the design and implementation of discharge plans for post-surgical gastric cancer patients. Methods: A systematic literature search was performed on the Cochrane Central Register of Controlled Studies, Elsevier Scopus and the library database of the National University of Colombia. These articles were assessed for relevance and underwent thematic analysis. Findings: The search returned nine relevant articles in English and Spanish. They suggested that discharge plans should start from first contact with a nurse and integrate the patient and their family and carers into the process of home self-care and recovery. These plans should also guide nurses to provide ongoing patient education, nutritional interventions and psychosocial support, as well as prevention of thromboembolism and assistance with symptom management and coming to terms with a new life situation. Conclusions: Discharge plans reduce the negative impact of the disease and invasive procedures on patients, families and health systems, reducing unplanned hospitalisation and readmission. There is a need to develop and test supportive care programmes that are designed to meet the needs of patients and focus on improving patients' quality of life after this life-changing surgery.