Abstract: Objective:To systematically retrieve, evaluate, and summarize the best evidence for the management of abdominal distension after liver cancer surgery, providing an evidence-based basis for clinical practice.
Methods:From database inception to October 30, 2024, a computerized search was conducted in Chinese and English databases, including UpToDate, BMJ Best Practice, Cochrane Library, PubMed, CNKI, and Wanfang Data etc, to identify clinical guidelines, expert consensuses, systematic reviews, randomized controlled trials, and evidence summaries related to postoperative abdominal distension in liver cancer patients. The search timeframe spanned. Two researchers independently performed literature screening, quality assessment, and evidence extraction. The evidence was graded and synthesized according to the feasibility, appropriateness, meaningfulness, effectiveness principles.
Results:From 826 publications, a total of 13 articles were included, consisting of 7 guidelines, 1 expert consensus, 2 randomized controlled trials, and 3 studies of other types. Finally, 15 pieces of best evidence were summarized from aspects such as preoperative management (multidisciplinary team collaboration, intestinal preparation), postoperative management (analgesia, fluid management, dietary recovery, early ambulation), and auxiliary interventions (chewing gum, application of lactulose). This fills the gap in the research dimensions of domestic studies, covers the synergy of multiple links and adaptation to individual differences, and is more comprehensive and precise than similar studies. It clarifies the mechanism by which multi-dimensional interventions synergistically improve abdominal distension, reaching the advanced level in China.
Conclusions:The evidence system constructed in this study lays a foundation for standardized and individualized evidence-based nursing for postoperative abdominal distension in liver cancer, helping clinical practice to accurately meet patients' needs. However, the evidence system still needs to be improved, and further high-quality studies are required to continuously optimize the management practice of postoperative abdominal distension in liver cancer.

Key words: Post-hepatectomy, Abdominal distension management, Evidence summary, Evidence-based nursing, Enhanced recovery after surgery