Çocuklarda Laparoskopik Kolesistektominin Günübirlik Uygulanmasını Etkileyen Faktörler
Küçük Resim Yok
Tarih
2017
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Erişkinlerde günübirlik laparoskopik kolesistektomi (LK) yaygın olarak kullanılmaktadır. Çocuklarda ise bu konuyla ilgili deneyim sınırlıdır. Bu çalışmada çocuklarda günübirlik LK uygulamasını etkileyen faktörlerin ortaya konması amaçlanmıştır.Gereç ve Yöntemler: Haziran 2005-Temmuz 2016 tarihleri arasında kliniğimizde semptomatik veya asemptomatik kolelitiyazis nedeniyle elektif LK uygulanmış hastaların kayıtları geriye dönük olarak incelendi. Hastalar yatış sürelerine göre gruplandırıldı. Gruplar; demografik veriler, eşlik eden hastalık, öykü, anestezi ve ameliyat özellikleri, postoperatif tedavi ve beslenme durumlarına göre karşılaştırıldı. Analiz için t-test ve ki-kare kullanıldı.Bulgular: Ortalama yaşı 10,4 olan 167 olgu çalışmaya dahil edildi. Hiçbir olguda açığa dönüş gerekmezken tüketim koagülopatisi gelişen bir olgu dışında komplikasyon gelişmedi. Günübirlik (GB), tek gecelik yatış (TGY) ve uzamış yatış (UY) gruplarını sırasıyla 50, 92 ve 25 olgu oluşturdu. Gruplar preoperatif özellik ve postoperatif ağrı düzeyi açılarından benzerdi. Geçirilmiş kolesistit öyküsü UY grubunda daha sıktı (p<0,05). Anestezi süresi GB grubunda en az, UY grubunda en fazlaydı (p<0,006). UY grubunda perioperatif minör komplikasyonlar GB grubuna göre daha sıktı (p=0,03). Oral beslenmeye geçiş süreleri GB, TGY ve UY gruplarında sırasıyla 3,2, 5,4 ve 14,8 saatti (p<0,009). Hiçbir olguda yeniden yatış gerekmedi.Sonuç: GB LK eşlik eden hastalığı olmayan çocuklarda güvenle uygulanabilir. Anestezi süresi ve oral beslenmenin geciktirilmeden başlanması en önemli faktörlerdir.
Aim: Laparoscopic cholecystectomy (LC) as day surgery is widely performed on adults; however, experience in pediatric LC in an out-patient setting is limited. We aimed to review our experience and investigate related factors.Materials and Methods: Medical records of patients who underwent elective LC from June 2005 to July 2016 were retrospectively reviewed. Patients were grouped according to the duration of hospital stay, and patient characteristics and outcome were compared. T-test and chi-square were used for statistical analysis.Results: A hundred and sixty-seven patients with a mean age of 10.4 years were enrolled. There was no conversion to open surgery, with only one postoperative complication in a patient with consumption coagulopathy. Same-day discharge (SDD), overnight stay (ONS) and prolonged stay (PS) groups were constituted of 50, 92, 25 patients respectively. All groups had similar preoperative characteristics and median postoperative pain scores. Previous history of cholecystitis and underlying hematological diseases were more common in the PS group (p<0.05). Duration of anesthesia was shortest in SDD, longest in PS groups (p<0.006). Perioperative minor complications were more common in the PS group than the SDD group (p=0.03). Mean time for oral feeding was 3.2, 5.4 and 14.8 hours for SDD, ONS and PS groups respectively (p<0.009). There was no readmission.Conclusion: LC may safely be performed as day surgery in children without comorbidities. Shorter duration of anesthesia and early oral feeding seem to play a key role in SDD in these cases.
Aim: Laparoscopic cholecystectomy (LC) as day surgery is widely performed on adults; however, experience in pediatric LC in an out-patient setting is limited. We aimed to review our experience and investigate related factors.Materials and Methods: Medical records of patients who underwent elective LC from June 2005 to July 2016 were retrospectively reviewed. Patients were grouped according to the duration of hospital stay, and patient characteristics and outcome were compared. T-test and chi-square were used for statistical analysis.Results: A hundred and sixty-seven patients with a mean age of 10.4 years were enrolled. There was no conversion to open surgery, with only one postoperative complication in a patient with consumption coagulopathy. Same-day discharge (SDD), overnight stay (ONS) and prolonged stay (PS) groups were constituted of 50, 92, 25 patients respectively. All groups had similar preoperative characteristics and median postoperative pain scores. Previous history of cholecystitis and underlying hematological diseases were more common in the PS group (p<0.05). Duration of anesthesia was shortest in SDD, longest in PS groups (p<0.006). Perioperative minor complications were more common in the PS group than the SDD group (p=0.03). Mean time for oral feeding was 3.2, 5.4 and 14.8 hours for SDD, ONS and PS groups respectively (p<0.009). There was no readmission.Conclusion: LC may safely be performed as day surgery in children without comorbidities. Shorter duration of anesthesia and early oral feeding seem to play a key role in SDD in these cases.
Açıklama
Anahtar Kelimeler
Pediatri
Kaynak
The Journal of Pediatric Research
WoS Q Değeri
Scopus Q Değeri
Cilt
4
Sayı
4
