Jing He; Da Ma; Huijuan Jiang; Huijuan Tang; Qian Mi; Renli Cheng
Volume 26, Issue 1 , 2024
Abstract
Background: Laparoscopic cholecystectomy is widely used in clinical treatment for gallbladder diseases. Rapid rehabilitation surgical nursing can significantly reduce the incidence of postoperative complications and shorten the hospital stay of patients. Moreover, it is supported by evidence-based ...
Read More
Background: Laparoscopic cholecystectomy is widely used in clinical treatment for gallbladder diseases. Rapid rehabilitation surgical nursing can significantly reduce the incidence of postoperative complications and shorten the hospital stay of patients. Moreover, it is supported by evidence-based medicine and has been widely used in clinical nursing. Nonetheless, there are few studies analyzing the influence of rapid rehabilitation surgical nursing on patients undergoing laparoscopic cholecystectomy.
Objective: This study aimed to assess the clinical use of rapid rehabilitation surgical nursing on laparoscopic cholecystectomy patients.
Methods: This study was performed on patients who underwent laparoscopic cholecystectomy in Suzhou Hospital of Anhui Medical University, Suzhou, China between June 2021 and July 2022. The participants were divided into a research group (RG) and a control group (CG) based on different nursing plans, with 51 cases in each group. A routine nursing plan was implemented for CG patients while rapid rehabilitation surgical nursing was implemented for RG patients.
Results: The bowel sound recovery time, the first time of anal exhaust and getting out of bed, as well as the length of hospital stay in the RG decreased, in contrast to the CG. Prior to nursing, no significance was found in visual analog scale (VAS) scores, interleukin 6 (IL-6) and C-reactive protein (CRP) levels, as well as World Health Organization Quality of Life Scale (WHOQOL-BREF) scores of both groups. After nursing, VAS scores decreased in both groups, and the scores of RG were lower, compared to those of CG. The IL-6 and CRP levels increased in both groups, but those in the RG were lower, in comparison with those in the CG. The WHOQOL-BREF scores of all dimensions increased in both groups, compared to the baseline, and those in the RG were higher, relative to the CG. Additionally, the total occurrence of complications in the RG decreased, compared to the CG. Besides, the total nursing satisfaction in the RG was elevated, relative to the CG (P<0.05).
Conclusion: Application of rapid rehabilitation surgical nursing can expedite postoperative rehabilitation, reduce pain and stress response, promote quality of life, and lessen complications in patients undergoing laparoscopic cholecystectomy, thereby, increasing nursing satisfaction, which is worthy of promotion.
Alireza Tavassoli; Tooraj Zandbaf; Alireza Rezapanah
Volume 23, Issue 10 , 2021
Abstract
Background: Situs Inversus Totalis (SIT) is a rare and silent autosomal recessive disease in which all organs are on the opposite side. Diagnosis of gallbladder diseases will be difficult due to these anatomical changes. Laparoscopic cholecystectomy is the standard treatment for gallbladder diseases ...
Read More
Background: Situs Inversus Totalis (SIT) is a rare and silent autosomal recessive disease in which all organs are on the opposite side. Diagnosis of gallbladder diseases will be difficult due to these anatomical changes. Laparoscopic cholecystectomy is the standard treatment for gallbladder diseases but is technically challenging for patients.
Case presentation: Two 52- and 64-year-old women with known SIT who complained of intermittent epigastric pain and nausea after eating fatty and bulky meals were examined. With the help of abdominal ultrasound, a gallbladder on the left side of the abdomen with multiple gallstones was shown.
Conclusion: Since the successful primary cholecystectomy was performed on a patient with SIT in 1991, several modifications have been made for port insertion. Surgeons try to overcome technical problems by making various adjustments compared to conventional laparoscopic cholecystectomy.
Laparoscopic cholecystectomy in patients with SIT is safe. However, laparoscopic cholecystectomy is challenging due to anatomical changes in the SIT. Our proposed method of port placement helps right-handed surgeons for safer and easier dissection.
Mehmet Ali Gok; Mehmet Tolga Kafadar; Serkan Fatih Ye?en
Volume 22, Issue 11 , 2020
Abstract
Background: Cholecystectomy is a widespread abdominal procedure. A period of 8-hour-fasting for this relatively rapid surgery negatively affects the patients comfort.
Objectives: The current study aimed to evaluate the effects of the presurgical intake of carbohydrates on patients comfort.
Methods: ...
Read More
Background: Cholecystectomy is a widespread abdominal procedure. A period of 8-hour-fasting for this relatively rapid surgery negatively affects the patients comfort.
Objectives: The current study aimed to evaluate the effects of the presurgical intake of carbohydrates on patients comfort.
Methods: This prospective study was carried out on 42 cholecystectomy patients (with the American Society of Anesthesiologists grade of I-II) divided into two groups. The patients in group 1 underwent laparoscopic cholecystectomy after an 8-hour-fasting period. The subjects in group 2 received a carbohydrate-rich solution with 12.5% dextrose before the surgery (125 g of sugar melted in 1 L of water; 800 and 200 mL 8 and 2 h before the surgery, respectively). Thirst, hunger, and nausea at the 9th preoperative hour and 30 min before the surgery in addition to nausea and vomiting at the 2nd, 8th, and 24th postoperative hours were assessed in both groups.
Results: The mean age and body mass index (BMI) values of the patients were 48.38±12.68 years and 29.85±5.20 kg/m2, respectively. The mean operational time was 36.5 min (range: 26-114 min). No difference was observed between the two groups in terms of age, BMI, and operational time. The investigation 30 min before cholecystectomy revealed that the rates of hungry and thirsty patients were higher in group 1, compared to those reported for group 2 (P=0.003 and P=0.032). Nevertheless, at the 2nd and 8th postoperative hours, the rate of patients? complaining of nausea was higher in group 2 in comparison to that of group 1 (P=0.048 and P=0.014).
Conclusion: It is suggested that the intake of carbohydrate-rich fluids up to the preoperative 2nd hour decreased presurgical hunger/thirst. The results of this study are in line with the findings of previous studies. It is believed that the intake of CHO-rich solutions up to 2 h before surgery may provide comfort by decreasing hunger/thirst. Nevertheless, it is necessary to take into account a potential rise in a feeling of nausea among these patients.
