Abstract
<title>Abstract</title> <p>Objective To preliminarily evaluate the clinical utility of an interventional center-led risk-score-guided nursing pathway in patients with resistant hypertension undergoing laparoscopic adventitial renal sympathetic radiofrequency ablation, also referred to as laparoscopic renal denervation (RDN). Methods This was a single-center retrospective cohort study. Thirty-two patients with resistant hypertension who underwent laparoscopic adventitial RDN at the Second Affiliated Hospital of Soochow University from October 2022 to April 2025 were included. Patients were assigned to groups according to whether they were treated before or after implementation of the nursing pathway: 16 to the conventional nursing group and 16 to the risk-score-guided pathway group. The pathway was led by the interventional center nursing team and implemented in collaboration with cardiology, urology, anesthesiology, operating room, and ward nursing teams. Perioperative blood pressure fluctuation, postoperative recovery, pain, anxiety-related scores, self-care ability, medication adherence, complications, and available follow-up blood pressure outcomes were compared between groups. Results Baseline characteristics, preoperative nursing risk scores, risk-level distribution, and surgery-related variables were comparable between groups (all P > 0.05). Compared with the conventional nursing group, the pathway group had a lower intraoperative maximum blood pressure fluctuation amplitude (P = 0.009), shorter time to first ambulation (P = 0.014), shorter time to first flatus (P = 0.031), and shorter hospital stay (P = 0.015). The pathway group also had lower 24-hour postoperative VAS scores, lower HAMA scores at discharge, and higher ESCA and MMAS-8 scores at discharge (all P < 0.05). Transient hypotension and the occurrence of at least one postoperative complication tended to be less frequent in the pathway group (P = 0.172 and P = 0.153, respectively). Among patients with completed follow-up records, blood pressure levels were lower at 6 and 12 months, and the 12-month blood pressure control rate tended to be higher in the pathway group. Conclusion The interventional center-led risk-score-guided nursing pathway may reduce intraoperative blood pressure fluctuation, promote early ambulation and gastrointestinal recovery, improve anxiety-related scores, self-care ability, and medication adherence at discharge, and may support post-discharge blood pressure management in patients undergoing laparoscopic adventitial RDN. The pathway provides an operable model for extending interventional nursing into the perioperative and post-discharge management of this emerging procedure.</p>