Cirugía de la pared abdominal después del SARS-CoV-2: ¿es hora de restablecer los procedimientos no esenciales pospuestos? / Abdominal Wall Surgery After SARS-CoV-2: Time to Reestablish Postponed Non-essential Procedures?

La pandemia por el COVID-19 nos ha encontrado desprotegidos ante la dificultad para dar una respuesta sanitaria adecuada y rápida. La red de hospitales del sistema sanitario público ha dispuesto la mayoría de los recursos para el tratamiento de los pacientes afectos por la infección. Las cirugías no esenciales (no prioritarias) han sido aplazadas. El reinicio óptimo y proporcionado de estas cirugías no prioritarias puede representar un problema. En el presente artículo se ofrece una perspectiva técnica y no técnica del reinicio de las cirugías no prioritarias desde la óptica de la cirugía de la pared abdominal

Pandemic by the COVID-19 has found us unprotected to provide an adequate and rapid sanitary response. The hospital network of our public health system has provided most of the resources for the treatment of patients affected by the infection. Non-essential (non-priority) surgeries have been postponed. The optimal and proportionate reestablishment of these non-priority surgeries can be a problem. This article offers a technical and non-technical view of reestablishment non-priority surgeries from the perspective of abdominal wall surgery

[Abdominal Wall Surgery After SARS-CoV-2: Time to Reestablish Postponed Non-essential Procedures?] / Cirugía de la pared abdominal después del SARS-CoV-2: ¿es hora de restablecer los procedimientos no esenciales pospuestos?

Pandemic by the COVID-19 has found us unprotected to provide an adequate and rapid sanitary response. The hospital network of our public health system has provided most of the resources for the treatment of patients affected by the infection. Non-essential (non-priority) surgeries have been postponed. The optimal and proportionate reestablishment of these non-priority surgeries can be a problem. This article offers a technical and non-technical view of reestablishment non-priority surgeries from the perspective of abdominal wall surgery.

Valoración del impacto de la educación preoperatoria en la colecistectomía laparoscópica ambulatoria. Ensayo prospectivo aleatorizado doble ciego / Evaluation of the impact of preoperative education in ambulatory laparoscopic cholecystectomy. A prospective, double-blind randomized trial

Introducción: La colecistectomía laparoscópica ambulatoria es segura y proporciona mejor aprovechamiento de recursos sanitarios y satisfacción percibida, sin repercutir en la calidad asistencial. La educación preoperatoria ha demostrado disminución del estrés, del dolor y náuseas postoperatorios en algunas intervenciones. El objetivo principal del estudio es valorar el impacto de la educación preoperatoria sobre el dolor postoperatorio en la colecistectomía laparoscópica ambulatoria. Los objetivos secundarios fueron evaluar las náuseas postoperatorias, morbilidad, ingresos no esperados, readmisiones, calidad de vida y grado de satisfacción. Métodos: Estudio prospectivo, aleatorizado, doble ciego. Entre abril de 2014 y mayo de 2016 fueron intervenidos 62 pacientes de colecistectomía laparoscópica ambulatoria. Criterios de inclusión: ASA I-II, edad 18-75 años, criterios de ambulatorización, ecografía abdominal con colelitiasis. Aleatorización de pacientes en grupo A: educación preoperatoria intensificada, y grupo B: control. Resultados: Sesenta y dos pacientes incluidos, 44 mujeres (71%), 18 hombres (29%), edad media 46,8 años (20-69). Media IMC de 27,5. Tasa de ambulatorización del 92%, 5 casos requirieron ingreso, 2 fueron por náuseas. La media del grado de dolor según EVA fue a las 24 h de 2,9 en el grupo A y de 2,7 en el grupo B. No complicaciones graves ni reingresos. La encuesta de satisfacción y el test de calidad de vida no mostraron diferencias entre grupos. Conclusiones: Las bajas cifras de dolor y complicaciones impiden evidenciar diferencias atribuibles a la educación preoperatoria. Sin embargo, un correcto protocolo de información se debería integrar en la preparación preoperatoria de los pacientes (AU)

Introduction: Outpatient laparoscopic cholecystectomy is a safe procedure and provides a better use of health resources and perceived satisfaction without affecting quality of care. Preoperative education has shown less postoperative stress, pain and nausea in some interventions. The principal objective of this study is to assess the impact of preoperative education on postoperative pain in patients undergoing ambulatory laparoscopic cholecystectomy. Secondary objectives were: to evaluate presence of nausea, morbidity, hospital admissions, readmissions rate, quality of life and satisfaction. Methods: Prospective, randomized, and double blind study. Between April 2014 and May 2016, 62 patients underwent outpatient laparoscopic cholecystectomy. Inclusion criteria: ASA I-II, age 18-75, outpatient surgery criteria, abdominal ultrasonography with cholelithiasis. Patient randomization in two groups, group A: intensified preoperative education and group B: control. Results: Sixty-two patients included, 44 women (71%), 18 men (29%), mean age 46,8 years (20-69). Mean BMI 27,5. Outpatient rate 92%. Five cases required admission, two due to nausea. Pain scores obtained using a VAS was at 24-hour, 2,9 in group A and 2,7 in group B. There were no severe complications or readmissions. Results of satisfaction and quality of life scores were similar for both groups. Conclusions: We did not find differences due to intensive preoperative education. However, we think that a correct information protocol should be integrated into the patient's preoperative preparation (AU)

Evaluation of the impact of preoperative education in ambulatory laparoscopic cholecystectomy. A prospective, double-blind randomized trial. / Valoración del impacto de la educación preoperatoria en la colecistectomía laparoscópica ambulatoria. Ensayo prospectivo aleatorizado doble ciego.

INTRODUCTION: Outpatient laparoscopic cholecystectomy is a safe procedure and provides a better use of health resources and perceived satisfaction without affecting quality of care. Preoperative education has shown less postoperative stress, pain and nausea in some interventions. The principal objective of this study is to assess the impact of preoperative education on postoperative pain in patients undergoing ambulatory laparoscopic cholecystectomy. Secondary objectives were: to evaluate presence of nausea, morbidity, hospital admissions, readmissions rate, quality of life and satisfaction. METHODS: Prospective, randomized, and double blind study. Between April 2014 and May 2016, 62 patients underwent outpatient laparoscopic cholecystectomy. INCLUSION CRITERIA: ASA I-II, age 18-75, outpatient surgery criteria, abdominal ultrasonography with cholelithiasis. Patient randomization in two groups, group A: intensified preoperative education and group B: control. RESULTS: Sixty-two patients included, 44 women (71%), 18 men (29%), mean age 46,8 years (20-69). Mean BMI 27,5. Outpatient rate 92%. Five cases required admission, two due to nausea. Pain scores obtained using a VAS was at 24-hour, 2,9 in group A and 2,7 in group B. There were no severe complications or readmissions. Results of satisfaction and quality of life scores were similar for both groups. CONCLUSIONS: We did not find differences due to intensive preoperative education. However, we think that a correct information protocol should be integrated into the patient's preoperative preparation. Registered in ISRCTN number ISRCTN83787412.