Analysis of perioperative stress in patients after simultaneous laparoscopic Surgery
DOI:
https://doi.org/10.11603/2414-4533.2020.4.11778Keywords:
hiatal hernia, lapaproscopic fundoplication, surgical stressAbstract
The aim of the work: based on the variability of the heart rhythm to assess the degree of perioperative stress in patients with laparoscopic treatment of hiatal hernia and simultaneous operations.
Material and Methods. A survey of 332 patients with hiatal hernia from 2015 to 2019. All of them underwent laparoscopic crurography with fundoplication according to Tupe. Two groups were formed. Group 1 – the main group included patients who underwent simultaneous laparoscopic surgical treatment of hiatal hernia and gallstone disease –126 people. Group 2 – control group, patients underwent only laparoscopic crurography and fundoplication – 206 patients. To assess the operative stress the day before the surgery and 1, 2, 3, 6, 12 hours and 1, 2 and 3 days of the postoperative period, a variation pulsegram was registered using the cardiocomplex “CardioLab +” with subsequent determination of the main statistical characteristics according to the method of R. M. Baevsky. Estimation of the probability of differences between the control and main groups was performed using the nonparametric Mann-Whitney test.
Results and Discussion. Mono-interventions for hiatal hernia and simultaneous protrusion under the conditions of our developed technique of laparoscopic operations in the postoperative period in all periods of observation are accompanied by almost identical deviations of statistical indicators of variability of cardiac rhythm. The absence of statistically significant differences in the dynamics of the postoperative period between the groups of patients with mono- and simultaneous interventions on the level of sympathicotonia and the degree of centralization of heart rate regulation indicates the same level of postoperative stress and indicates the safety and viability of simultaneous operations.
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