Soltani R, Pazouki A, Shirali A,
Volume 69, Issue 8 (6 2011)
Abstract
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Background: The aim of this study was to compare operating time and short-term
complications of laparoscopic transabdominal preperitoneal hernia repair during
reperitonealization in Trendelenburg versus reverse-Trendelenburg positions.
Methods : Thirty-nine patients with inguinal hernia were enrolled in this clinical
trial. Study was done in Milad and Rasoul Akram hospitals in Tehran, Iran,
during 2008-2010. The patients neither were pregnant nor did they have any signs of
peritonitis, strangulation, perforation or infection. Moreover, they had a Body
Mass Index (BMI) below 35 kg/m2 and were physically fit for general anesthesia. The
participants were divided into two groups by block randomization. The first (20) and the second (19) groups of patients underwent
laparoscopic herniorrhaphy in Trendelenburg and reverse-Trendelenburg positions.
Respectively all the operations were performed by one surgeon. The patients were
visited one day and one week after the surgery.
Results : Most frequent complications were rupture in peritoneal repair in 9 patients (23%), skin site bleeding in one
patient (2.6%), and peritoneal tension in 33 patients (84.6%) patients. Duration of surgery and peritoneal repair took a significantly
longer time in Trendelenburg versus the reverse-Trendelenburg position. There were
no differences in duration for returning to work or resumption of daily activities
between the two groups. Pain in the first day following surgery was
statistically more severe in the Trendelenburg group.
Conclusion: This
study demonstrated that reverse-Trendelenburg position took less time for herniorrhaphy
and peritoneal repair than Trendelenburg position, although the complications
were the same.
Leila Sadati , Ehsan Golchini , Abdolreza Pazouki , Fatemeh Jesmi , Mohadeseh Pishgahroudsari ,
Volume 72, Issue 4 (July 2014)
Abstract
Background: Nowadays, new methods are emerging each month for a better operation with fewer complications. Laparoscopic surgery have remarkable advantages, Compared to open, such as smaller incision, less manipulation of the digestive system, less postoperative pain, fewer wound complication and faster discharge from the hospital. Therefore it is preferred by patients and surgeons and is replacing the traditional open surgical methods. However, any operation causes significant panic for patients and lack of knowledge about the surgical method is found to cause poor surgical outcomes, such as recovery time after the surgery we evaluated the effect of preoperative education on the recovery time of laparoscopic cholecystectomy candidates.
Methods: This randomized clinical control trial was performed at Imam Khomeini and Alborz Hospitals in Karaj from February 2010 till January 2011. Using randomized sampling method, 100 female candidates for laparoscopic cholecystectomy were divided into two equal groups of case and control. The case group received detailed information about operating room’s condition, surgical equipment, anesthesia method, advantages and disadvantages of laparoscopic procedures, and patient’s role in self-care at recovery, whilst the control group received no education before the surgery. The two groups were compared regarding recovery time based on Aldrete modified checklist and mean time to reach the Aldrete consciousness score of 9 and the incidence of nausea was assessed among them.
Results: The analysis showed that there was a significant difference between the mean time to reach Aldrete consciousness modified checklist score of 9 between the case and control group (18.04±3.87 vs. 29.66±5.44, respectively, P<0.001), therefore the case group had shorter recovery time than the control group. 10 of the case group (20%) and 3 of the control group (6%) had nausea after recovery (P=0.037, OR=0.255 (CI 95%: 0.066-0.992)).
Conclusion: Preoperative education of patients can significantly decrease the recovery time after laparoscopic cholecystectomy surgery. Therefore, it is strongly recommended to include the preoperative education in routine care of laparoscopic cholecystectomy patients for better surgical outcomes.
