ARE THE MODELS FOR EARLY POSTOPERATIVE RECOVERY IN LAPAROSCOPIC TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE APPLICABLE - OUR EXPERIENCE

Authors

  • Stefka Georgieva Medical University, Faculty of Public Health, Sofia
  • Nadya Manolova Medical University, Faculty of Public Health, Sofia

Keywords:

nurse care, enhanced postoperative recovery, laparoscopic surgery

Abstract

Introduction: At the dawn of the new millennium, technological advances in both diagnosis and therapy make the treatment of hiatal hernia and gastroesophageal reflux not only anatomically but also physiologically sound surgical practice. No less important is the quality of life and early postoperative recovery of patients.
Material and methods: The 112-month period September 2010 - December 2019 was analyzed, during which 330 patients with diaphragmatic hernias were operated, of which 322 laparoscopic and 8 conventional. Of the hernias in the laparoscopic group, 306 were primary and 16 recurrent. 12 of the recurrences were after laparoscopic antireflux surgery and 4 after conventional surgery.
Of the 330 patients, 242 were women and 88 were men. The mean age was 57.4 years for men and 51.6 years for women.
Results: The verticalization of the patients in the early postoperative period in the laparoscopic group is between the second and the third postoperative hour, and on the next postoperative day all patients are independently moved and able to self-care. The nasogastric tubes (calibration) are removed at the end of the operation, before removal from anesthesia. A urethral catheter was placed in almost all patients, but was removed in the second postoperative hour during the first movement of the patients. Patients in the laparoscopic group were discharged on average on 3.9 postoperative days (postoperative stay 1 - 16.8 days). The cases with a longer postoperative hospital stay are those with postoperative complications. The standard discharge for more than 90% of laparoscopically operated patients is on the second postoperative day.
Postoperative complications in the early postoperative period were observed in 22 patients (6.66%).
We have no cases of perioperative mortality.
Patients were followed in the postoperative period from 30 days to 6 years. We observe 16 cases of recurrence (4.84%).
Discussion: In the clinic we apply a protocol for early postoperative recovery, using the criteria of ERAS (Enhanced Recovery After Surgery), which allows maximum reduction of hospital stay, reduction of postoperative complications, better quality of life for patients and minimization of costs (in optimal size without compromising the quality of the activity).
Conclusion: The application of early postoperative recovery systems reduces the frequency and severity of postoperative complications, shortens the postoperative hospital period, leads to a better quality of life for patients and is medically, socially and economically feasible.

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Published

2020-08-17

How to Cite

Georgieva, S., & Manolova, N. (2020). ARE THE MODELS FOR EARLY POSTOPERATIVE RECOVERY IN LAPAROSCOPIC TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE APPLICABLE - OUR EXPERIENCE. KNOWLEDGE - International Journal, 41(3), 513–517. Retrieved from https://ikm.mk/ojs/index.php/kij/article/view/782