Araştırma Makalesi
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Laparoskopik bilateral tubal sterilizasyon operasyonu sırasında dren uygulanmasının postoperatif barsak hareketlerine etkisi

Yıl 2022, , 485 - 490, 01.07.2022
https://doi.org/10.31362/patd.1047843

Öz

Amaç: Laparoskopik bilateral tubal sterilizasyon (L/S BTS) operasyonu sırasında dren kullanımı rutin bir uygulama olmayıp kanama şüphesi durumunda hastanın yakın takibini mümkün kılar. Bu çalışma ile L/S BTS operasyonu sırasında dren uygulamasının postoperatif dönemde gastrointestinal sistem açısından olası faydalarını araştırmak amaçlanmıştır.
Gereç ve yöntem: Turhal Devlet Hastanesi’nde Haziran 2019 ile Mart 2021 arasında L/S BTS uygulanmış hastaların dosya verileri retrospektif olarak tarandı. Çalışmaya L/S BTS operasyonu sırasında dren uygulanmış 22 hasta kadın ile L/S BTS operasyonu sırasında dren uygulanmamış olan 42 hasta kadın olmak üzere toplamda 64 hasta kadın dahil edildi. Gruplar; yaş, ameliyat sonrası gaz-feçes çıkışına kadar geçen süre, karın ağrısı, karın içi apse-hematom oluşumu, yara yeri enfeksiyonu, ameliyat süresi ve hastaneden taburcu olma süresi açısından karşılaştırıldı.
Bulgular: Dren kullanılan hastalar ile dren kullanılmayan hastalar karşılaştırdıklarında; dren kullanılan hastalarda gaz ve gaita çıkış saatlerinin daha erken olduğu bulundu (p=0,003 ve p=0,018). Ancak dren kullanılan hastalar ilk 12 saatte daha fazla abdominal ağrı hissetmekteydiler (p=0,029). Yine dren konulan hastalarda daha fazla yara yeri infeksiyonu oluştuğu gözlendi (p=0,008).
Sonuç: L/S BTS yapılan hastalara peroperatif dren uygulanması ile postoperatif dönemde gaz-gaita çıkışı daha erken saatte olmakta ancak abdominal ağrı hissi daha fazla olmaktaydı. Dren uygulaması ile postoperatif erken dönemde boşalan laparoskopi gazının bağırsak hareketlerini olumlu yönde etkilediği kanaatindeyiz.

Kaynakça

  • 1. Moss C, Isley MM. Sterilization: A Review and Update. Obstet Gynecol Clin North Am. 2015 Dec;42(4):713-724. DOI: 10.1016/j.ogc.2015.07.003
  • 2. Stuart GS, Ramesh SS. Interval Female Sterilization. Obstet Gynecol. 2018 Jan;131(1):117-124. DOI: 10.1097/AOG.0000000000002376
  • 3. Jokinen E, Heino A, Karipohja T, Gissler M, Hurskainen R. Safety and effectiveness of female tubal sterilization by hysteroscopy, laparoscopy, or laparotomy: a register based study. BJOG. 2017 Nov;124(12):1851-1857. DOI: 10.1111/1471-0528.14719
  • 4. Chao TE, Mandigo M, Opoku-Anane J, Maine R. Systematic review of laparoscopic surgery in low- and middle-income countries: benefits, challenges, and strategies. Surg Endosc. 2016 Jan;30(1):1-10. DOI: 10.1007/s00464-015-4201-2
  • 5. Sao CH, Chan-Tiopianco M, Chung KC, Chen YJ, Horng H C, Lee WL et al. Pain after laparoscopic surgery: Focus on shoulder-tip pain after gynecological laparoscopic surgery. J Chin Med Assoc. 2019 Nov;82(11):819-826. DOI: 10.1097/JCMA.0000000000000190
  • 6. Nursal TZ, Yildirim S, Tarim A et al. Effect of drainage on postoperative nausea, vomiting and pain after laparoscopic cholecystectomy. Langenbecks ArchSurg 2003;388:95–100. DOI: 10.1007/s00423-003-0374-6
  • 7. Taş B, Donatsky AM, Gögenur I. Techniques to reduce shoulder pain after laparoscopic surgery for benign gynaecological disease: a systematic review. Gynecol Surg 2013;10:169–175. https://doi.org/10.1007/s10397-013-0791-7
  • 8. Vecchio R, Intagliata E, Marchese S, Battaglia S, Cacciola RR, Cacciola E. Surgical drain after open or laparoscopic splenectomy: is it needed or contraindicated? G Chir. 2015 May-Jun;36(3):101-105. PMCID: PMC4511037
  • 9. Kerimoglu OS, Yilmaz SA, Pekin A, İncesu F, Dogan NU, İlhan T T et al. Effect of drainage on postoperative pain after laparoscopic ovarian cystectomy. J Obstet Gynaecol. 2015 Apr;35(3):287-289. DOI: 10.3109/01443615.2014.948824
  • 10. Chan K, Welsh A, Abbott J. Residual pelvic fluid using two types of drains at laparoscopy: a randomized controlled trial. Obstet Gynecol. 2008 Jun;111(6):1293-1297. DOI: 10.1097/AOG.0b013e31817589cd
  • 11. Abbott J, Hawe J, Srivastava P, Hunter D, Garry R. Intraperitoneal gas drain to reduce pain after laparoscopy: randomized masked trial. Obstet Gynecol. 2001 Jul;98(1):97-100. DOI: 10.1016/s0029-7844(01)01383-7
  • 12. Swift G, Healey M, Varol N, Maher P, Hill D. A prospective randomised double-blind placebo controlled trial to assess whether gas drains reduce shoulder pain following gynaecological laparoscopy. Aust N Z J Obstet Gynaecol. 2002 Aug;42(3):267-270. DOI: 10.1111/j.0004-8666.2002.00267.x
  • 13. Asgari Z, Hosseini R, Rastad H. Does Peritoneal Suction Drainage Reduce Pain After Gynecologic Laparoscopy? Surgical Laparoscopy Endoscopy & Percutaneous Techniques. 2018; 28 (2):73-76. DOI: 10.1097/SLE.0000000000000490
  • 14. Raymond AP, Chan K, Deans R, Bradbury R, Vancaillie TG, Abbott JA. A comparative, single-blind, randomized trial of pain associated with suction or non-suction drains after gynecologic laparoscopy. J Minim Invasive Gynecol. 2010 Jan-Feb;17(1):16-20. http://dx.doi.org/10.1016/j.jmig.2009.04.010
  • 15.Georgiou C, Demetriou N, Pallaris T, Theodosopoulos T, Katsouyanni K, Polymeneas G. Is the routine use of drainage after elective laparoscopic cholecystectomy justified? A randomized trial. J Laparoendosc Adv Surg Tech A. 2011 Mar;21(2):119-123. https://doi.org/10.1089/lap.2010.0003
  • 16. Craciunas L, Stirbu L, Craciunas L, Stirbu L, Tsampras N. The use of a peritoneal gas drain following gynecological laparoscopy: a systematic review. Eur J Obstet Gynecol Reprod Biol 2014 Aug;179:224-228. https://doi.org/10.1038/s41598-021-92762-3
  • 17. Gurer A, Dumlu EG, Dikili E, Kiyak G, Ozlem N. Is a Drain Required after Laparoscopic Cholecystectomy? Eurasian J Med. 2013 Oct;45(3):181-184. DOI: 10.5152/eajm.2013.37
  • 18. Shen CC, Huang FJ, Hsu TY, et al. A prospective, randomized study of closed-suction drainage after laparoscopic-assisted vaginal hysterectomy. The Journal of the American Association of Gynecologic Laparoscopists. 2002; 9 (3):346-352. DOI: 10.1016/s1074-3804(05)60415-x

The effect on postoperative bowel movements of intraoperative drain application during laparoscopic bilateral tubal sterilization

Yıl 2022, , 485 - 490, 01.07.2022
https://doi.org/10.31362/patd.1047843

Öz

Purpose: The use of a drain during a laparoscopic bilateral tubal sterilization (L/S BTS) operation is not a routine procedure, but enables close follow up of a patient when there is suspected bleeding. The aim of this study was to investigate the potential benefits of drain placement during L/S BTS operation in respect of the gastrointestinal system postoperatively.
Materials and methods: A retrospective evaluation was made of patients applied with L/S BTS at Turhal State Hospital between June 2019 and March 2021. The study included a total of 64 women; 22 applied with a drain during L/S BTS operation and 42 women not applied with a drain. The two groups of patients were compared in respect of age, time to postoperative gas-faeces output, abdominal pain, the formation of intra-abdominal abscess-hematoma, wound site infection, operation time, and time of hospital discharge.
Results: In the comparison of the patients with and without a drain, there was seen to be earlier gas and faeces output in the patients where a drain was used (p=0.003, p=0.018). Greater abdominal pain was felt in the first 12 hours (p=0.029), and a higher rate of wound site infection was observed (p=0.008) in the patients with a drain.
Conclusion: Perioperative placement of a drain in patients applied with L/S BTS was seen to result in earlier gas-faeces output but greater abdominal pain. Drain application in the early postoperative period can be considered to have a positive effect on the bowel movements evacuating laparoscopy gas.

Kaynakça

  • 1. Moss C, Isley MM. Sterilization: A Review and Update. Obstet Gynecol Clin North Am. 2015 Dec;42(4):713-724. DOI: 10.1016/j.ogc.2015.07.003
  • 2. Stuart GS, Ramesh SS. Interval Female Sterilization. Obstet Gynecol. 2018 Jan;131(1):117-124. DOI: 10.1097/AOG.0000000000002376
  • 3. Jokinen E, Heino A, Karipohja T, Gissler M, Hurskainen R. Safety and effectiveness of female tubal sterilization by hysteroscopy, laparoscopy, or laparotomy: a register based study. BJOG. 2017 Nov;124(12):1851-1857. DOI: 10.1111/1471-0528.14719
  • 4. Chao TE, Mandigo M, Opoku-Anane J, Maine R. Systematic review of laparoscopic surgery in low- and middle-income countries: benefits, challenges, and strategies. Surg Endosc. 2016 Jan;30(1):1-10. DOI: 10.1007/s00464-015-4201-2
  • 5. Sao CH, Chan-Tiopianco M, Chung KC, Chen YJ, Horng H C, Lee WL et al. Pain after laparoscopic surgery: Focus on shoulder-tip pain after gynecological laparoscopic surgery. J Chin Med Assoc. 2019 Nov;82(11):819-826. DOI: 10.1097/JCMA.0000000000000190
  • 6. Nursal TZ, Yildirim S, Tarim A et al. Effect of drainage on postoperative nausea, vomiting and pain after laparoscopic cholecystectomy. Langenbecks ArchSurg 2003;388:95–100. DOI: 10.1007/s00423-003-0374-6
  • 7. Taş B, Donatsky AM, Gögenur I. Techniques to reduce shoulder pain after laparoscopic surgery for benign gynaecological disease: a systematic review. Gynecol Surg 2013;10:169–175. https://doi.org/10.1007/s10397-013-0791-7
  • 8. Vecchio R, Intagliata E, Marchese S, Battaglia S, Cacciola RR, Cacciola E. Surgical drain after open or laparoscopic splenectomy: is it needed or contraindicated? G Chir. 2015 May-Jun;36(3):101-105. PMCID: PMC4511037
  • 9. Kerimoglu OS, Yilmaz SA, Pekin A, İncesu F, Dogan NU, İlhan T T et al. Effect of drainage on postoperative pain after laparoscopic ovarian cystectomy. J Obstet Gynaecol. 2015 Apr;35(3):287-289. DOI: 10.3109/01443615.2014.948824
  • 10. Chan K, Welsh A, Abbott J. Residual pelvic fluid using two types of drains at laparoscopy: a randomized controlled trial. Obstet Gynecol. 2008 Jun;111(6):1293-1297. DOI: 10.1097/AOG.0b013e31817589cd
  • 11. Abbott J, Hawe J, Srivastava P, Hunter D, Garry R. Intraperitoneal gas drain to reduce pain after laparoscopy: randomized masked trial. Obstet Gynecol. 2001 Jul;98(1):97-100. DOI: 10.1016/s0029-7844(01)01383-7
  • 12. Swift G, Healey M, Varol N, Maher P, Hill D. A prospective randomised double-blind placebo controlled trial to assess whether gas drains reduce shoulder pain following gynaecological laparoscopy. Aust N Z J Obstet Gynaecol. 2002 Aug;42(3):267-270. DOI: 10.1111/j.0004-8666.2002.00267.x
  • 13. Asgari Z, Hosseini R, Rastad H. Does Peritoneal Suction Drainage Reduce Pain After Gynecologic Laparoscopy? Surgical Laparoscopy Endoscopy & Percutaneous Techniques. 2018; 28 (2):73-76. DOI: 10.1097/SLE.0000000000000490
  • 14. Raymond AP, Chan K, Deans R, Bradbury R, Vancaillie TG, Abbott JA. A comparative, single-blind, randomized trial of pain associated with suction or non-suction drains after gynecologic laparoscopy. J Minim Invasive Gynecol. 2010 Jan-Feb;17(1):16-20. http://dx.doi.org/10.1016/j.jmig.2009.04.010
  • 15.Georgiou C, Demetriou N, Pallaris T, Theodosopoulos T, Katsouyanni K, Polymeneas G. Is the routine use of drainage after elective laparoscopic cholecystectomy justified? A randomized trial. J Laparoendosc Adv Surg Tech A. 2011 Mar;21(2):119-123. https://doi.org/10.1089/lap.2010.0003
  • 16. Craciunas L, Stirbu L, Craciunas L, Stirbu L, Tsampras N. The use of a peritoneal gas drain following gynecological laparoscopy: a systematic review. Eur J Obstet Gynecol Reprod Biol 2014 Aug;179:224-228. https://doi.org/10.1038/s41598-021-92762-3
  • 17. Gurer A, Dumlu EG, Dikili E, Kiyak G, Ozlem N. Is a Drain Required after Laparoscopic Cholecystectomy? Eurasian J Med. 2013 Oct;45(3):181-184. DOI: 10.5152/eajm.2013.37
  • 18. Shen CC, Huang FJ, Hsu TY, et al. A prospective, randomized study of closed-suction drainage after laparoscopic-assisted vaginal hysterectomy. The Journal of the American Association of Gynecologic Laparoscopists. 2002; 9 (3):346-352. DOI: 10.1016/s1074-3804(05)60415-x
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kadın Hastalıkları ve Doğum
Bölüm Araştırma Makalesi
Yazarlar

Bugra Sahin 0000-0003-0429-3085

Gizem Cura Şahin 0000-0001-5696-4683

Yayımlanma Tarihi 1 Temmuz 2022
Gönderilme Tarihi 26 Aralık 2021
Kabul Tarihi 18 Mart 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

AMA Sahin B, Cura Şahin G. The effect on postoperative bowel movements of intraoperative drain application during laparoscopic bilateral tubal sterilization. Pam Tıp Derg. Temmuz 2022;15(3):485-490. doi:10.31362/patd.1047843
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