Patienteneinschätzungen und Analyse der frühpostoperativen Rekonvaleszenz bei der laparoskopischen Cholezystektomie unter dem Aspekt einer ambulanten Durchführung
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Philipps-Universität Marburg
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Abstract
Laparoscopic cholecystectomy (LC) is one of the most frequently performed
minimally invasive visceral-surgical operations and has established itself as a
particularly standardised, safe, and stressless procedure. For many years it has been
considered as a gold standard in the treatment of symptomatic cholecystolithiasis.
The diminished stress related to LC is shown by countless positive effects in the
patients convalescence.
These benefits comprise the need of a smaller inlet into the abdominal cavity thus
causing less trauma to the abdominal wall and showing better cosmetic results,
considerably reduced postoperative pain, a low rate of wound healing disturbances,
and a reduced hospitalisation and convalescence time thus enabling the patients a
faster return to everyday- and professional life.
In the health care system these positive effects of minimally invasive surgery
brought a trend towards shifting some of the procedures to outpatient medical care
and overnight hospitalisation.
The aim of this prospective observational study was to analyse whether patients
regard LC as an outpatient treatment and to monitor their convalenscence after
having undergone such a procedure.
For the period of one year, from 1. October 2012 to 30. September 2013,
150 patients of the ASA I and II group who underwent elective LC were included
in this study. All patients were supervised post-surgically in the ward for at least 2
days.
In this study, during the preoperative period, the patients willingness to undergo an
outpatient treatment was evaluated. Furthermore, the course of surgery,
intraoperative findings, complications, and postoperative convalescence. For this
purpose the essential parameters of postoperative convalescence such as
postoperative pain, feeling of nausea and vomiting as well as the time until first
mobilisation and oral absorption of food and liquids were analysed.
Additionally, the patients were asked for their own point of view regarding their
discharge from hospital by taking into consideration their general impression of the
treatment and their postsurgical condition.
This study could prove low stress related to LC and fast postoperative
convalescence. However, the immediate postsurgical concomitants can be very
stressful for patients. With regard to an outpatient treatment pain and postoperative
fatigue turned out to be the substantially limiting factors.
During the study period it could be observed that only 20% of the patients would
give their consent to an outpatient LC. Nevertheless, 74% of the patients felt being
able to be discharged from hospital in the course of the first day after surgery.
In the case of an elective LC the present study shows that reducing the hospital time
to overnight hospitalisation is possible and even desired by patients.
Outpatient LC, however, even if it is medically acceptable in many cases, should be
offered only those patients who wish to be treated this way and who fulfill the strict
selection criteria.
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Dates
Created: 2014Issued: 2014-10-29Updated: 2014-10-29
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
Day SurgeryLaparoscopic CholecystectomyAmbulatory SurgeryPostoperative convalescence
DFG-subjects
GenesungPostoperative PhaseKleine ChirurgieLaparoskopieCholezystektomie
DDC-Numbers
610
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Firla, Margarete Johanna (1061168514): Patienteneinschätzungen und Analyse der frühpostoperativen Rekonvaleszenz bei der laparoskopischen Cholezystektomie unter dem Aspekt einer ambulanten Durchführung. : Philipps-Universität Marburg 2014-10-29. DOI: https://doi.org/10.17192/z2014.0694.
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This item has been published with the following license: In Copyright