1
|
Golod N, Saienko V, Liannoi M, Rusyn L, Yaniv O, Ivanovska O. The dynamics of recovery of external breathing function in patients after laparoscopic cholecystectomy in the acute period under the influence of the rehabilitation program. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:208-213. [PMID: 38592980 DOI: 10.36740/wlek202402104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Aim: To determine the dynamics of renewal of the function of external respiration in patients after laparoscopic cholecystectomy at the acute stage of rehabilitation under the influence of a rehabilitation program. PATIENTS AND METHODS Materials and Methods: The study is randomized, simple with blinded assessors. The forced vital capacity (FVC, l), forced expiratory volume in the first second (FEV1, l) and peak expiratory flow rate (PEFR, l/s) were assessed. Spirometry was performed 120 patients on the first day of admission of patients to the surgical department for surgical intervention, on the second day and on the day of discharge. Methods of mathematical statistics: arithmetic mean (M) and standard error of the mean (}m), Student's t-test were calculated, differences at p<0,05 were considered statistically significant. RESULTS Results: It has been established that laparoscopic cholecystectomy leads to a statistically significant decrease in the parameters of respiratory function in all age categories. More pronounced positive dynamics of respiratory function in the group of respiratory therapy. It was established that without respiratory therapy on the day of discharge there was no restoration (р<0.05) in groups of elderly patients of group of FVC l, FEV1 l, PEFR l/s; in middle-aged patients did no restoration FEV1, l, PEFR, l/s; in younger patients there was no recovery of FEV1, l. CONCLUSION Conclusions: The results of the study indicate the effectiveness of the introduction of diaphragmatic breathing exercises in combination with early mobilization at the acute and subacute stages of rehabilitation in patients after laparoscopic cholecystectomy in order to restore the function of the respiratory system.
Collapse
Affiliation(s)
- Nataliya Golod
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | | | - Mykhailo Liannoi
- SUMY STATE PEDAGOGICAL UNIVERSITY NAMED AFTER A. S. MAKARENKO, SUMY, UKRAINE
| | | | - Olesia Yaniv
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Olga Ivanovska
- NATIONAL UNIVERSITY OF PHYSICAL EDUCATION AND SPORTS OF UKRAINE, KYIV, UKRAINE
| |
Collapse
|
2
|
Calini G, Brollo PP, Quattrin R, Bresadola V. Predictive Factors for Drain Placement After Laparoscopic Cholecystectomy. Front Surg 2022; 8:786158. [PMID: 35187046 PMCID: PMC8847274 DOI: 10.3389/fsurg.2021.786158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/29/2021] [Indexed: 12/07/2022] Open
Abstract
PurposeCurrently, surgical drainage during a laparoscopic cholecystectomy (LC) is still placed in selected patients. Evidence of the non-beneficial effect of the surgical drain comes from studies with a heterogeneous population. This preliminary study aims to identify any clinical, demographic, or intraoperative predictive factors for a surgical drain placement during LC as the first step to identify population for a prospective randomized study.MethodThe study was conducted in a single referral center and academic hospital between 2014 and 2018. Patients who underwent unconverted LC were divided into two groups: Group A (drain) and Group B (no drain). We explored baseline, preoperative, intraoperative characteristics, and postoperative outcomes.ResultsBetween 409 patients who underwent LC: 90 (22%) patients were in Group A (drain). Age >64 years, male sex, cholecystitis, Charlson comorbidity index (CCI) ≥ 1, experienced surgeon, intraoperative technical difficulties, need for an additional trocar, operative time >60 min, and estimated blood loss >10 ml were predictive factors at univariate analysis. While at multivariate analysis, cholecystitis (odds ratio [OR]: 2.8, 95% CI:1.5–5.1; p < 0.001), CCI ≥ 1 (OR:1.9, 95% CI:1.0–3.5; p = 0.05), intraoperative technical difficulties (OR: 3.6, 95% CI:1.8–6.2; p < 0.001), need of an additional trocar (OR: 2.5, 95% CI: 1.4–4.4; p < 0.005), and estimated blood loss >10 ml (OR: 3.0, 95% CI:1.7–5.3; p < 0.0001) were predictive factors for a surgical drain placement during LC.ConclusionsThis study identified predictive factors that currently drive the surgeons to a surgical drain placement after LC. Randomized prospective studies are needed to define the use of drain placement in these selected patients.
Collapse
Affiliation(s)
- Giacomo Calini
- Department of Medicine, General Surgery Department and Simulation Center, Academic Hospital of Udine, University of Udine, Udine, Italy
| | - Pier Paolo Brollo
- Department of Medicine, General Surgery Department and Simulation Center, Academic Hospital of Udine, University of Udine, Udine, Italy
| | - Rosanna Quattrin
- Department of Organization of Hospital Services, Academic Hospital of Udine, Udine, Italy
| | - Vittorio Bresadola
- Department of Medicine, General Surgery Department and Simulation Center, Academic Hospital of Udine, University of Udine, Udine, Italy
- *Correspondence: Vittorio Bresadola ; orcid.org/0000-0002-0098-3540
| |
Collapse
|
3
|
Prevot F, Fuks D, Cosse C, Pautrat K, Msika S, Mathonnet M, Khalil H, Mauvais F, Regimbeau JM. The Value of Abdominal Drainage After Laparoscopic Cholecystectomy for Mild or Moderate Acute Calculous Cholecystitis: A Post Hoc Analysis of a Randomized Clinical Trial. World J Surg 2017; 40:2726-2734. [PMID: 27351713 DOI: 10.1007/s00268-016-3605-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Although the preoperative management of mild and moderate (Grade I-II) acute calculous cholecystitis (ACC) has been standardized, there is no consensus on the value of abdominal drainage after early cholecystectomy. METHODS In a post hoc analysis of a randomized controlled trial (NCT01015417) focused on the value of postoperative antibiotic therapy in patients with ACC, we determined the value of abdominal drainage in patients having undergone laparoscopic cholecystectomy for Grades I-II ACC. All postoperative complications were analyzed after using a propensity score. A post hoc test was used to assess the statistical robustness of our results. RESULTS Of the 414 enrolled patients, 178 did not have abdominal drainage (forming the no-drainage group) and 236 had drainage (the drainage group). After matching on PS, the deep incisional site infection was 1.1 versus 0.8 %, p = 0.78. This result is similar for the superficial incisional site infections; the distant infections; the overall morbidity, and the readmission rate. Only the hospital length of stay was significantly longer in the drainage group (3.3 vs. 5.1 days, p = 0.003). Neither abdominal drainage nor the absence of postoperative antibiotic therapy was found to be a risk factor for deep incisional site infections. CONCLUSIONS The use of abdominal drainage depends on the surgeon's personal preferences but is often used in high-risk populations. However, abdominal drainage does not appear to be of any benefit (in terms of postoperative outcomes) and may even compromise recovery in patients having undergone early laparoscopic cholecystectomy for mild or moderate ACC.
Collapse
Affiliation(s)
- Flavien Prevot
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France
- French National Surgical Research Network, Amiens, France
| | - David Fuks
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France
- French National Surgical Research Network, Amiens, France
| | - Cyril Cosse
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France
- INSERM U1088, Amiens, France
- Digestive Surgery Methodology Unit, Amiens University Medical Center, Amiens, France
- Clinical Research Center, Amiens University Medical Center, Amiens, France
- French National Surgical Research Network, Amiens, France
| | - Karine Pautrat
- Department of Digestive Diseases, Lariboisière Hospital, Paris, France
- French National Surgical Research Network, Amiens, France
| | - Simon Msika
- General and Digestive Surgery Department, Louis Mourier Hospital, Colombes, France
- French National Surgical Research Network, Amiens, France
| | - Muriel Mathonnet
- Department of Digestive Surgery, Dupuytren Hospital, Limoges, France
- French National Surgical Research Network, Amiens, France
| | - Haitham Khalil
- Department of Digestive Surgery, Rouen University Medical Center, Rouen, France
- French National Surgical Research Network, Amiens, France
| | - François Mauvais
- Department of Digestive Surgery, Beauvais Hospital, Beauvais, France
- French National Surgical Research Network, Amiens, France
| | - Jean-Marc Regimbeau
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France.
- Clinical Research Center, Amiens University Medical Center, Amiens, France.
- French National Surgical Research Network, Amiens, France.
- EA4294, Jules Verne University of Picardie, Amiens, France.
- Department of Digestive and Oncological Surgery, New University Hospital Centre, Avenue René Laennec, Cedex 1, F-80054, Amiens, France.
| |
Collapse
|