scholarly journals Maintaining Optimal Surgical Conditions With Low Insufflation Pressures is Possible With Deep Neuromuscular Blockade During Laparoscopic Colorectal Surgery

Medicine ◽  
2016 ◽  
Vol 95 (9) ◽  
pp. e2920 ◽  
Author(s):  
Myoung Hwa Kim ◽  
Ki Young Lee ◽  
Kang-Young Lee ◽  
Byung-Soh Min ◽  
Young Chul Yoo
Keyword(s):  
Colorectal Surgery ◽  
Neuromuscular Blockade ◽  
Laparoscopic Colorectal Surgery ◽  
Surgical Conditions

Post-operative respiratory outcomes associated with the use of sugammadex in laparoscopic colorectal cancer surgery: a retrospective, propensity score matched cohort study

2020 ◽  
Keyword(s):  
Colorectal Surgery ◽  
Propensity Score ◽  
Adverse Events ◽  
Propensity Score Matching ◽  
Neuromuscular Blockade ◽  
Laparoscopic Colorectal Surgery ◽  
Anesthesia Care ◽  
Care Hospital ◽  
Post Anesthesia Care Unit ◽  
Clinical Benefits

Sugammadex can rapidly reverse neuromuscular blockade and has several advantages over cholinesterase inhibitors. It is unclear, however, whether administration of sugammadex in the absence of intraoperative deep neuromuscular blockade has direct clinical benefits. The present study retrospectively assessed the ability of sugammadex to prevent post-operative respiratory adverse events in patients undergoing laparoscopic colorectal surgery in the absence of routine deep neuromuscular blockade. The medical records of patients who underwent laparoscopic colorectal surgery from 2014 to 2018 in a tertiary care hospital were reviewed. Patients who underwent reversal of neuromuscular blockade with sugammadex or pyridostigmine were subjected to propensity score matching. To assess their relative effects on post-operative adverse respiratory events (defined as a composite of SpO2 < 94% in the post-anesthesia care unit, additional oxygen supplementation during ward transfer or stay, and emergency use of sugammadex in the post-anesthesia care unit), the incidence of these effects was compared in propensity score matched groups of patients treated with sugammadex or pyridostigmine. Of the 602 patients, 210 remained in each group after propensity score matching. The incidence of post-operative respiratory adverse events did not differ significantly in the two groups. These findings suggest that the unrestricted administration of sugammadex not preceded by intra-operative deep neuromuscular blockade does not have clinical benefits, when compared with pyridostigmine, in preventing post-operative respiratory adverse events.

scholarly journals IMPACT OF LAPAROSCOPIC COLORECTAL SURGERY ON BODY IMAGE

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
A Fernández Candela ◽  
L Sánchez-Guillén ◽  
L García Catalá ◽  
C Curtis Martínez ◽  
M Bosch Ramírez ◽  
...  
Keyword(s):  
Body Image ◽  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Wound Complication ◽  
Descriptive Study ◽  
Surgical Quality ◽  
Body Image Scale ◽  
Study Results ◽  
The Impact ◽  
Observational Descriptive Study

Abstract INTRODUCTION The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality. MATERIAL AND METHODS We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included. RESULTS The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia). The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression. CONCLUSION Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.

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