JMIR Publications

ABSTRACT

Background:

As of 2022, patient postoperative non-compliance can increase the risk of complications by up to 52.4% after laparoscopic abdominal surgery, however, no singular pre-operative education intervention (POEI) demonstrates consistent improvement in patient outcomes across the procedures.

Objective:

This study aims to determine which POEI could be the most effective on patient outcomes by systematically reviewing all the POEI reported in the literature.

Methods:

4,753 articles investigating POEI (e.g. videos, presentations, mobile applications, one-on-one education or coaching) were collected from the PubMed, EMBASE, and Scopus databases. Inclusion criteria were: adult patients undergoing abdominal laparoscopic surgery, randomized controlled trials, and provided postoperative outcomes. Exclusion criteria included: not published in English and no outcomes reported. Title/abstract and full-text articles with POEI randomized controlled studies were screened based on the criteria through a blinded, dual review using Covidence. Study quality was assessed through the Cochrane Risk of Bias tool. Included articles were analyzed for educational content, intervention timing, intervention type, and postoperative outcomes appropriate for a particular surgery. This study protocol has been registered to PROSPERO: CRD42023438698.

Results:

Only 17 studies matched our criteria, with 1,831 patients undergoing laparoscopic cholecystectomy, bariatric surgery (gastric bypass and gastric sleeve), and colectomy. 15 studies reported a statistically significant improvement in at least one patient postoperative outcome. None of these studies had an overall Cochrane high risk of bias. 41.2% of the included studies used one-on-one education or coaching improved outcomes in almost all surgery types, while educational videos had the greatest statistically significant impact for anxiety, nausea, and pain postoperatively (p<0.01). Group education or coaching demonstrates significant improvement in weight, BMI, exercise, and depressive symptoms in 33.3% of the laparoscopic gastric bypass studies.

Conclusions:

Direct education or coaching (one-on-one or group-based) positively impacts postoperative outcomes more than the newer POEIs (e.g. mobile applications). Clinical Trial: This study protocol has been registered to PROSPERO: CRD42023438698.