Assessment of feasibility of simultaneous laparoscopic interventions in the treatment of cholelithiasis with surgical abdominal comorbidity
DOI:
https://doi.org/10.11603/2414-4533.2019.4.10719Keywords:
gallstone disease, ERAS, simultaneous, surgery, laparoscopyAbstract
The aim of the work: to determine and evaluate the quality of medical care for patients with gallstone disease and comorbid surgical pathology, using modern scales of evaluation of the status for surgical patients to decide which strategy of treatment is the best for these patients.
Materials and Methods. 410 patients who were treated surgically in Volyn Regional Clinical Hospital in the Department of Invasive Diagnosis and Treatment with combined pathology and 681 patients who were treated surgically with only one surgical pathology. Null hypothesis technique used, Pearson analysis, Tukey, Mann-Whitney.
Results and Discussion. Simultaneous surgical treatment is more appropriate and better meets current standards of care. Patients' condition after surgery did not differ significantly in both groups. Also, there were no clinically significant difference in terms of recovery. Morbidity in both groups was null. Simultaneous operations haven’t shown up any rise of stress for patients’ body. There were no significant difference in glycaemia or any other objective data (laboratory data, or data of scales assessing the patients condition) in both groups of patients. There were no dramatical rising of the duration of operation and general anesthesia also this rising didn`t lead to bigger perioperative risks. The difference of intrahospital stay between both groups had no significant odds, and the difference was no more than one bed-day. Especially if compared with two different hospitalization for two different operations. The technique is effective and shows its advantages over conventional methods.
References
Marianne, E. Weiss, Linda, L, Costa, Olga Yakusheva, & Kathleen, L. Bobay (2014). Validation of patient and nurse short forms of readability for hospital discharge scale and their relationship to return to hospital. Health Serv. Res., 49 (1), 304-317.
Asoh, T., Shirasaka, C., Uchido, I., Baldini G., Bagry H., & Carli F. (1987). Effects of indomethacin on endocrine responses and nitrogen loss after surgery. Ann. Surg., 206, 770-776. DOI: https://doi.org/10.1097/00000658-198712000-00014
Smith, R., Kee, A., & Barrat S. (2008). Depth of anesthesia with desflu rane does not influence the endocrine methabolic response to pelvic surgery. Acta Anaesth. Scand., 52, 99-105.
Beilin, B., Martin, F., & Shavit, Y. (2002). Multimodal analgesia and intravenous nutrition preserves total body protein following major upper gastrointestinal surgery. Reg. Anesth. Pain Med., 27, 15-22.
Beilin, B., Bessler,,H., & Mayburd, E. (1989). Supression of natural killer cell activity by high dose narcotic anesthesia in rats. Brain Behave Immun., 3, 129-137. DOI: https://doi.org/10.1016/0889-1591(89)90013-5
Bent, J., Paterson, J., & Mashiter, K. (2003). Effects of preemptive analgesia on pain and cytokine production in the postoperative period. Anesthesiology, 98, 151-155. DOI: https://doi.org/10.1097/00000542-200301000-00024
Bromage, P., & Shibata, H. (1978). Effects of high dose fentanyl anaesthesia on the established metabolic and endocrine re sponse to surgery. Anaesthesia, 39, 19-23.
Halliday, D., Cassuto, J., Nellgard, P., & Stage, L. (1997). Continuous epidural blockade arrests of postoperative decrease in muscle protein fractional synthetic rate in surgical patients. Anesthesiology, 86, 1033-1040. DOI: https://doi.org/10.1097/00000542-199705000-00005
Desborough, J., & Hall, G. (2001). The role of neuroinflammation and neuroimmune activation in persistent pain. Pain, 90, 1-6. DOI: https://doi.org/10.1016/S0304-3959(00)00490-5
Desborough, J. (1989). Modification of the hormonal and metabolic response to surgery by narcotics and general anes thesia. Clin. Anaesthesiol., 3, 317-334.
Garlick, P., Burns, H., & Palmer, R. (2000). The stress response to trauma and surgery. Br. J. Anaesth., 85, 109-117. DOI: https://doi.org/10.1093/bja/85.1.109
Kehlet, H. (2006). The stress response to surgery: release mechanism and the role of pain relief. Acta Chir. Scand., (55), 22.
Kehlet, H. (1997). Multimodal approach to control postoperative pathophysiology and rehabilitation. Br. J. Anaesth., 78, 606-617. DOI: https://doi.org/10.1093/bja/78.5.606
Kehlet, H., & Wilmore, D. (1998). Modification of responses to surgery by neural blockade: clinical implications. Neural blockade in clinical anesthesia and management of pain. Cousins, M., & Bridenbaugh, P. (Eds.). Philadelphia, PA: Lippincott.
Surgical patients' experience of readiness for hospital discharge and perceived quality of discharge teaching in acute care hospitals https://www.researchgate.net/publication/329954189_Surgical_Patients'_Experiences_of_Readiness_for_Hospital_Discharge_and_Perceived_Quality_of_Discharge_Teaching_in_Acute_Care_Hospitals
Marianne, E. Weiss, Olga Yakusheva, Kathleen L. Bobay, Linda Costa, Ronda G. Hughes (2019). Effect of implementing discharge readiness assessment in adult medical-surgical units on a 30-day return to hospital. The READI Randomized Clinical Trial. JAMA Netw Open. 2 (1), e187387. doi: 10.1001 / jamanetworkopen.2018.7387.
Weiss, M., Piacentine, L., Lokken, L., Ancona, J., Archer, J., Gresser, S., Holmes, S., Toman, S., Toy, A., & Vega-Stromberg T. (2007). Perceived readiness for hospital discharge in adult medical-surgical patients. Clin. Nurse Spec., 21 (1), 31-42. DOI: https://doi.org/10.1097/00002800-200701000-00008
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