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首页> 外文期刊>Surgical Endoscopy >Recovery after laparoscopic parastomal hernia repair
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Recovery after laparoscopic parastomal hernia repair

机译：腹腔镜调节疝修补后恢复

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Background The perioperative care and postoperative period after laparoscopic hernia repair have not been well described. The aim of this study was to describe the postoperative course after laparoscopic parastomal hernia repair. Methods This was a prospective cohort study including consecutive patients undergoing laparoscopic parastomal hernia repair. The outcomes of interest were patient-reported pain, nausea and fatigue, time to stoma function, length of stay (LOS), use of transversus abdominis plane (TAP) block and epidural analgesia, the cumulative dose of morphine equivalent analgesics during the first 5 postoperative days, and postoperative complications. Results Forty patients were included, 20% had ileostomy and 80% colostomy. The mesh was placed according to Sugarbaker (87.5%) and keyhole (12.5%) technique. Twenty-two patients (55%) required peripheral nervous blockades postoperatively. The median number of days to stoma function was 3 days (range 2-3.8). The mean cumulative dose of morphine equivalent analgesics was 21.9 mg on the day of surgery, 27.8 mg on the first postoperative day (POD1), 23.9 on POD2, 17.3 mg on POD3, 15.3 mg on POD4, 8.9 mg on POD5, and 115.2 mg in total. The median LOS was 4 days (range 3-6). The incidence of postoperative complications was 25%. Conclusion Laparoscopic parastomal hernia repair carried a high risk of complications. Further, analgesic treatment after surgery was insufficient, with high opioid requirements postoperatively, and more than half of the patients required peripheral nervous blockades, indicating that postoperative pain is a major issue in this patient group. Improved postoperative care for these patients is required.
机译：背景腹腔镜疝修补术后的围手术期护理和术后时间尚未得到很好的描述。本研究的目的是描述腹腔镜下疝修补术后的过程。方法这是一项前瞻性队列研究，包括连续接受腹腔镜腹壁旁疝修补术的患者。相关结果包括患者报告的疼痛、恶心和疲劳、造口功能时间、住院时间（LOS）、腹横肌平面（TAP）阻滞和硬膜外镇痛的使用、术后前5天吗啡等效镇痛剂的累积剂量以及术后并发症。结果40例患者中，回肠造口占20%，结肠造口占80%。根据Sugarbaker（87.5%）和keyhole（12.5%）技术放置网片。22名患者（55%）术后需要外周神经阻滞。造口功能恢复的中位数天数为3天（范围2-3.8）。吗啡等效镇痛剂的平均累积剂量在手术当天为21.9 mg，术后第一天（POD1）为27.8 mg，POD2为23.9 mg，POD3为17.3 mg，POD4为15.3 mg，POD5为8.9 mg，总计115.2 mg。平均服务水平为4天（范围3-6）。术后并发症发生率为25%。结论腹腔镜下疝修补术并发症发生率高。此外，术后镇痛治疗不足，术后阿片类药物需求量高，超过一半的患者需要外周神经阻滞，这表明术后疼痛是该患者群体的主要问题。需要改善这些患者的术后护理。

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