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

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.

Anahtar Kelimeler

• Bilateral tubal sterilizasyon
• dren
• laparoskopi

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

Abstract

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.

Keywords

• Bilateral tubal sterilization
• drain
• laparoscopy

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