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

Yıl 2022, Cilt: 15 Sayı: 3, 485 - 490, 01.07.2022

Bugra Sahin Gizem Cura Şahin

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.

Anahtar Kelimeler

Bilateral tubal sterilizasyon, dren, laparoskopi

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

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.

Anahtar Kelimeler

Bilateral tubal sterilization, drain, laparoscopy

Kaynakça

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