scholarly journals Transcutaneous Electrical Acupoint Stimulation Accelerates the Recovery of Gastrointestinal Function after Cesarean Section: A Randomized Controlled Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Dandan Zhou ◽  
Bo Hu ◽  
Shan He ◽  
Xiaogang Li ◽  
Hui Gong ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Functional Recovery ◽  
Daily Living ◽  
Sham Group ◽  
Postoperative Hospital Stay ◽  
Control Group ◽  
Gastrointestinal Function ◽  
Daily Living Activities ◽  
Acupoint Stimulation

Background. Gastrointestinal functional recovery is an important factor affecting postoperative outcome. The aim of this study was to evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on gastrointestinal function in women undergoing cesarean section. Methods. 150 pregnant women undergoing cesarean section were randomly allocated into TEAS, nonacupoint stimulation (sham group), and no stimulation (control group). The primary outcome was indications of gastrointestinal functional recovery and the secondary outcomes included time to first mobilization, postoperative hospital stay, daily living activities at one week after surgery, postoperative side-effects, and serum levels of gastroenterological hormones. Results. The time to first flatus in TEAS group was significantly shorter compared to control (P=0.004) and sham groups (P=0.003). The time to first oral liquid and solid intake was significantly shorter than that in control (P<0.001; P=0.021) and sham group (P=0.019; P=0.037). Besides, postoperative hospital stay was shorter in TEAS group than in control group (P=0.031) and sham group (P<0.001). TEAS also promoted daily living activities (P=0.001 versus control group and P=0.015 versus sham group). Postoperative complications were similar among all the groups except for the incidence of abdominal distention 24 h after surgery (P=0.013; P=0.040). The motilin level was increased by TEAS (P=0.014 versus control group and P=0.020 versus sham group). Conclusion. TEAS accelerated gastrointestinal functional recovery after cesarean section, by reducing postoperative hospital length, and improved daily living activities after surgery. This effect was partially mediated by regulation of the gastroenterological hormones.

scholarly journals The Effect of the Gelatinous Lactulose for Postoperative Bowel Movement in the Patients Undergoing Cesarean Section

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Daisuke Shigemi ◽  
Kazuho Nakanishi ◽  
Miwa Miyazaki ◽  
Yoshie Shibata ◽  
Shunji Suzuki
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Bowel Movement ◽  
Bowel Function ◽  
Maternity Hospital ◽  
Postoperative Hospital Stay ◽  
Red Cross ◽  
Control Group ◽  
Gastrointestinal Function ◽  
Significant Difference

Lactulose is a non-digestible disaccharide formed from fructose and galactose. The objective of this study was to assess the effect of lactulose on gastrointestinal function after cesarean section. One hundred patients who underwent cesarean section at the Japanese Red Cross Katsushika Maternity Hospital were enrolled in this study. They were divided into 2 groups by randomization: (1) an L group that was treated with gelatinous lactulose (N = 48) and (2) a control group (C group) that did not receive gelatinous lactulose (N = 52). The interval between cesarean section and first postoperative flatus, defecation, and walking; appearance of symptoms of ileus; use of other medicines for stimulating bowel movement; properties and state of feces; and duration of postoperative hospital stay were compared between the two groups. The two groups did not show a significant difference in postoperative outcomes, except for the incidence of loose or watery stools (50% in the L group and 26.9% in the C group, P=0.03). This study could not demonstrate the apparent effectiveness of lactulose in improving bowel function after cesarean section. Therefore, a routine use of gelatinous lactulose after surgery may negatively impact the patients undergoing cesarean section.

Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Dr.Randa Mohammed AboBaker
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Chewing Gum ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Bowel Motility ◽  
Gum Chewing ◽  
Significant Difference

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.

Goal-directed Intraoperative Fluid Administration Reduces Length of Hospital Stay after Major Surgery

2002 ◽  
Vol 97 (4) ◽  
pp. 820-826 ◽  
Author(s):  
Tong J. Gan ◽  
Andrew Soppitt ◽  
Mohamed Maroof ◽  
Habib El-Moalem ◽  
Kerri M. Robertson ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Hospital Stay ◽  
Elective Surgery ◽  
Length Of Hospital Stay ◽  
Postoperative Hospital Stay ◽  
Fluid Administration ◽  
Major Surgery ◽  
Control Group ◽  
Surgical Morbidity ◽  
Protocol Group

Background Intraoperative hypovolemia is common and is a potential cause of organ dysfunction, increased postoperative morbidity, length of hospital stay, and death. The objective of this prospective, randomized study was to assess the effect of goal-directed intraoperative fluid administration on length of postoperative hospital stay. Methods One hundred patients who were to undergo major elective surgery with an anticipated blood loss greater than 500 ml were randomly assigned to a control group (n = 50) that received standard intraoperative care or to a protocol group (n = 50) that, in addition, received intraoperative plasma volume expansion guided by the esophageal Doppler monitor to maintain maximal stroke volume. Length of postoperative hospital stay and postoperative surgical morbidity were assessed. Results Groups were similar with respect to demographics, surgical procedures, and baseline hemodynamic variables. The protocol group had a significantly higher stroke volume and cardiac output at the end of surgery compared with the control group. Patients in the protocol group had a shorter duration of hospital stay compared with the control group: 5 +/- 3 versus 7 +/- 3 days (mean +/- SD), with a median of 6 versus 7 days, respectively ( = 0.03). These patients also tolerated oral intake of solid food earlier than the control group: 3 +/- 0.5 versus 4.7 +/- 0.5 days (mean +/- SD), with a median of 3 versus 5 days, respectively ( = 0.01). Conclusions Goal-directed intraoperative fluid administration results in earlier return to bowel function, lower incidence of postoperative nausea and vomiting, and decrease in length of postoperative hospital stay.

scholarly journals Flexible Ureteroscopic Lithotripsy Based on the Concept of Enhanced Recovery After Surgery

2021 ◽  
Author(s):  
Ling Shu ◽  
Ping Ao ◽  
Zhenxing Zhang ◽  
Dong Zhuo ◽  
Changbin Dong ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Operative Time ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Postoperative Hospital Stay ◽  
Control Group ◽  
Ureteroscopic Lithotripsy ◽  
Total Cost ◽  
Stone Removal

Abstract Background: To evaluate the efficacy of flexible ureteroscopic lithotripsy (FURSL) based on the concept of enhanced recovery after surgery (ERAS).Methods: 435 patients with upper urinary calculi between 2017-2020 were retrospectively analysed and assigned to ERAS group (ERAS management) and control group (traditional management). Operative time, postoperative ambulation time, postoperative hospital stay, total cost of hospitalization, postoperative complications and stone removal were compared. Results: 427 cases were successfully performed FURSL procedure with 4 cases of ERAS group (n = 216) and 4 cases of control group (n = 219) failed respectively. No postoperative complications occurred in either group except for fever and hematuria. There were no significant difference in postoperative fever and stone removal between the two groups (all p > 0.05). The patients in ERAS group had shorter operative time, shorter postoperative ambulation time, less postoperative severe hematuria, shorter postoperative hospital stay and lower total cost of hospitalization than those in control group (all p < 0.05).Conclusions: FURSL based on the concept of ERAS for the treatment of upper urinary tract calculi is safe and reliable, with rapid postoperative recovery, low cost of hospitalization and worthy of clinical promotion.

scholarly journals Development and Feasibility of the Early Rehabilitation Program on Postoperative Enhanced Recovery Following Minimally Invasive Esophagectomy: A Prospective Randomized Controlled Trial

2020 ◽  
Author(s):  
Funa Yang ◽  
Lijuan Li ◽  
Yanzhi Mi ◽  
Limin Zou ◽  
Xiaofei Chu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Physical Function ◽  
Enhanced Recovery ◽  
Rehabilitation Program ◽  
Postoperative Hospital Stay ◽  
Early Rehabilitation ◽  
Control Group ◽  
Function Recovery ◽  
Significant Difference ◽  
Physical Function Recovery

Abstract Background: Perioperative rehabilitation management is essential to enhanced recovery after surgery. Few reports, however, focused on quantitative, detailed early activity plans for patients after esophagectomy. Aim: The purpose of this research was to estimate the effect of the Early Rehabilitation Program (ERP) on the recovery of bowel function and physical function for patients undergoing esophagectomy. Method: In this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients were selected from June 2019 to February 2020 and assigned to the intervention group (IG) or the control group(CG) randomly. The participants in IG received an ERP strategy during the perioperative period, and the CG received routine care. The recovery of bowel and physical function, readiness for hospital discharge (RHD) and postoperative hospital stay were evaluated on the day of discharge. Results: 215 cases were enrolled and randomized to the CG (n=108) or IG (n=107). There was no significant difference between the two groups in terms of demographic and clinical characteristics and baseline physical function. After the ERP intervention, the IG group presented a significantly shorter time to first flatus (P<0.001) and to first bowel movement postoperative (P=0.024), and a better physical function recovery (P＜0.001), compared with the CG group. The analysis also showed that participants in the IG have higher scores of RHD and shorter length of postoperative stay than the CG (P＜0.05). Conclusion: The findings suggest that the ERP can improve bowel and physical function recovery, ameliorate patients' RHD, and shorten postoperative hospital stay for patients undergoing MIE.Trial registration：ClinicalTrials.gov Identifier: NCT01998230

scholarly journals THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUES

2018 ◽  
Vol 177 (4) ◽  
pp. 23-27
Author(s):  
S. E. Voskanyan ◽  
E. V. Naydenov ◽  
I. Yu. Uteshev ◽  
A. I. Artemiev ◽  
Yu. D. Udalov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Pancreatic Duct ◽  
Postoperative Period ◽  
Main Pancreatic Duct ◽  
Postoperative Hospital Stay ◽  
Control Group ◽  
Pancreatic Stump ◽  
Stump Closure ◽  
Pancreatic Fistulas

The  OBJECTIVE  is  to  study  the  effect  of application of different  pancreatic stump  closure techniques to  the  postoperative period,  the frequency and  severity  of postoperative complications including postoperative pancreatic fistulas  after distal pancreatectomies. MATERIAL AND METHODS.  The  clinical  material  consisted of 126  patients who  underwent distal  pancreatectomies  (isolated or  in  combination  with  surgical   interventions  on  the  adjacent organs of  the  abdominal cavity  and retroperitoneal space).  The  patients  were   divided  into  4  groups  depending  on  the  pancreatic  stump   closure  techniques (isolated suturing  of the  main  pancreatic duct  of the  pancreatic stump  with its omentization by gastrocolic omentum or local sealing its  by  hemostatic sponge  (control  group);  using  a  local  biological  glue  2-octylcyanoacrylate; using  the  Endoscopic Linear  Cutter  Echelon; external transduodenal  transnasal  drainage of the  enlarged main  pancreatic duct  of the  pancreatic stump). We  evaluated the  influence   of  different  pancreatic stump   closure techniques  after  distal  pancreatectomies on  the postoperative period  as well the  frequency and  severity  of postoperative pancreatic fistulas  depending on the  diameter of the main  pancreatic duct  of pancreatic stump.   RESULTS.  The  overall  rate  of postoperative  complications in the  control  group of patients was  45.8  %, and  was  due  to an  increase in the  frequency of specific  complications (35.4  %). The  most  frequent complication  in  the  control  group   of  patients  was   postoperative  pancreatic  fistulas   –  29.2   %.  The  statistically   significant decrease  of  frequency  and   severity   of  postoperative  complications,  frequency  and   severity   of  postoperative  pancreatic fistulas and decrease of postoperative hospital-stay after the application of the proposed different pancreatic stump closure techniques were  revealed in comparison with the  control  group  of patients. There  was  no  hospital  mortality.  CONCLUSION. Distal  pancreatectomy with  «standard»  pancreatic stump   closure techniques  accompanied by  high  frequency and  severity of postoperative complications, as well as postoperative pancreatic fistulas. The use of the proposed pancreatic stump closure techniques after  distal  pancreatectomy led  to  a  decrease of  the  frequency and  severity   of  postoperative  complications, a decrease of the  frequency and  severity  of postoperative pancreatic fistulas,  and  a decrease of the  postoperative hospital-stay.

scholarly journals Evaluation the effect of progressive muscle relaxation technique on fatigue and daily living activities in patients with Multiple Sclerosis

2021 ◽  
Vol 15 (6) ◽  
pp. 1773-1777
Author(s):  
Tayebeh Javdan ◽  
Elham Imani ◽  
Ahmad Agha Negahi
Keyword(s):  
Multiple Sclerosis ◽  
Daily Living ◽  
Muscle Relaxation ◽  
Progressive Muscle Relaxation ◽  
Relaxation Technique ◽  
Control Group ◽  
Daily Living Activities ◽  
Daily Living Activity ◽  
Significant Difference ◽  
Experimental Group

Aim: This is a Quasi-experimental study wich was carried out in order to determine the effects of applying progressive muscle relaxation on fatigue and daily living activity of MS patients. Background: Fatigue is one of the most common symptoms in people with multiple sclerosis (MS) and adversely affects their daily living activities. Methods: 80 MS Patients were selected then conducted in two group (40 experiments and 40 contorol). Data collector tools included: demographic questionnaire, fatigue severity scale and activity of daily living questionnaire which completed four times by two group (before̦ Third week, sixth and ninth after study), self-report checklists which completed only by experimental group. PMRT performed once a day for 8 week by experimental group. During study no intervention was done for control group. Results: repeated measures ANOVA showed that there is significant difference in mean score of fatigue between two group in 4 times (P<0/05). Also, the results showed that with progressive muscle relaxation at 4 times, daily activities in ADL and IADL sections were significantly increased (P<0/05) but there was no significant difference between the two groups (P>0/05). however, clinically significant differences were observed. Conclusions: Acording to these findingș applying PMRT decreased patient´s fatigue and improve independence in daily living activities. This study supports the effect of PMRT on fatigue and activities of daily living in patients with MS, and it is recommended that further studies be conducted on this subject in the future. Keywords: daily living activity, fatigue, progressive muscle relaxation technique, multiple sclerosis.

PS01.118: THE EFFECTS OF THE HERBAL MEDICINE DAIKENCHUTO (TJ-100) AFTER ESOPHAGEAL CANCER RESECTION, OPEN-LABEL, RANDOMIZED CONTROLLED TRIAL

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 83-83
Author(s):  
Akira Tangoku ◽  
Takeshi Nishino ◽  
Seiya Inoue ◽  
Takahiro Yoshida
Keyword(s):  
Randomized Controlled Trial ◽  
Esophageal Cancer ◽  
Body Weight ◽  
Herbal Medicine ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Control Group ◽  
Gastrointestinal Function ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background Daikenchuto (TJ-100), a traditional Japanese herbal medicine, is widely used in Japan. Its effects on gastrointestinal motility, microcirculation and its anti-inflammatory effect are known. The purpose of this prospective randomized controlled trial was to investigate the effect of TJ-100 after esophagectomy in esophageal cancer patients. Methods Forty patients to whom subtotal esophagectomy for esophageal cancer was planned at our institute from March 2011 to August 2013 were enrolled and divided into two groups at the point of determination of the operation schedule after informed consent: TJ-100 treated group (n = 20) and Control group (n = 20). The primary end-points were maintenance of the nutrition condition and the recovery of gastrointestinal function. The secondary end-points were the serum C-reactive protein (CRP) level and adrenomedullin level during the postoperative course, the incidence of postoperative complications, and the length of hospital stay after surgery. Results We examined 39 patients because one patient in TJ-100 group couldn’t perform a curative surgery. The mean age of the TJ-100 group patients was significantly older than that of the control group. The rate of body weight decrease at postoperative day 21 was significantly suppressed in the TJ-100 group (3.6% vs. 7.0%, P = 0.014), but the serum albumin levels were not significantly different between the groups. The recovery of gastrointestinal function regarding flatus, defecation, and oral intake showed no significant between the groups, but postoperative bowel ill symptoms tended to be rare in the TJ-100 group. There was no significant difference in hospital stay after surgery. The serum CRP levels at postoperative day 3 tended to be suppressed in the TJ-100 group (P = 0.126). The rate of increase in adrenomedullin levels tended to be high postoperatively in the TJ-100 group, but there was no significant difference. Conclusion TJ-100 treatment after esophagectomy prompts the recovery of gastrointestinal motility and minimizes body weight loss. Those effects might suppress the excess inflammatory reaction related to surgery Disclosure All authors have declared no conflicts of interest.

scholarly journals The effects of short-term preoperative physical therapy and education on early functional recovery of patients younger than 70 undergoing total hip arthroplasty

2008 ◽  
Vol 65 (4) ◽  
pp. 291-297 ◽  
Author(s):  
Aleksandra Vukomanovic ◽  
Zoran Popovic ◽  
Aleksandar Djurovic ◽  
Ljiljana Krstic
Keyword(s):  
Physical Therapy ◽  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Functional Recovery ◽  
Hip Arthroplasty ◽  
Control Group ◽  
Study Group ◽  
Short Term ◽  
Preoperative Education ◽  
Early Functional Recovery

Background/Aim. Hip arthroplasty is a routine operation which relieves pain in patients with osteoarthritis. The role of physical therapy after hip arthroplasty was recognized, but the importance of preoperative physical therapy and education is still to be judged. The aim of this paper was to investigate the effect of short-term preoperative program of education and physical therapy on patients' early functional recovery immediately after total hip arthroplasty (THA). Methods. This prospective study included 45 patients with hip osteoarthritis scheduled to undergo primary THA and admitted to the Department of Orthopedics of Military Medical Academy. They were randomized into 2 groups: study and control one (with and without preoperative education and physical therapy). Preoperative education was conducted through conversation (1 appointment with physiatrist) and brochure. The study group was instructed to perform exercises and basic activities from the postoperative rehabilitation program (2 practical classes with physiotherapist). Effects were measured with questionnaires (Harris, Oxford and Japanese Orthopaedic Association (JOA) hip scores), range of motion and visual analog scale of pain. Marks showing ability to perform basic activities and endurance were from 0 (did not perform activity) to 5 (independent and secure). Analyses examined differences between the groups over the preoperative and immediate postoperative periods and 15 months after the operation. Results. There were no differences between the groups at discharge according to pain, range of motion, Harris hip score and JOA hip score. Oxford hip score did not differ between the groups 15 months after the operation. The groups started to walk at the same time, but the study group walked up and down stairs (3.7?1.66 vs 5.37?1.46, p ? 0.002), used toilet (2.3?0.92 vs 3.2?1.24, p ? 0.02) and chair (2.2?1.01 vs 3.25?1.21, p ? 0.006) significantly earlier than the control group. On the third day after the operation the study group was significantly more independent than the control one while performing any basic activities (changing position in bed from supine to side lying, from supine to sitting on the edge of the bed, from sitting to standing, from standing to lying in the bad, standing, walking, using toilet and chair). At discharge the patients from the control group still needed the therapist help for walking up and down stairs (3?1.26), while the patients from the study group performed there activities independently (4.85?0.37) (p ? 0.000). Endurance while walking was significantly better in the study group than in the control one. The length of hospital stay after the operation was similar for both groups, but the patients from the study group needed significantly less classes with the therapist (5.2?2.35 vs 6.85?1.14, p ? 0.02) during hospital stay. Conclusion. The short-term preoperative program of education with the elements of physical therapy accelerated early functional recovery of patients (younger than 70) immediately after THA and we recommend it for routine use.

95 DIRECT ORAL FEEDING AFTER A MINIMALLY INVASIVE ESOPHAGECTOMY: A SINGLE-CENTER PROSPECTIVE COHORT STUDY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
L Fransen ◽  
T Janssen ◽  
M Aarnoudse ◽  
G Nieuwenhuijzen ◽  
M Luyer
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Functional Recovery ◽  
Complication Rate ◽  
Intervention Group ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Control Group ◽  
Invasive Esophagectomy ◽  
And Control

Abstract   A recent randomized controlled trial showed the safety and feasibility of direct oral feeding following a minimally invasive esophagectomy (MIE). However, significant differences were found regarding complication rate between hospitals, potentially influencing the effect of direct oral feeding. This study aimed to investigate the effect of direct oral feeding compared to the standard of care in a center with low anastomotic leakage and overall complication rates following a MIE. Methods Patients in this single-center prospective cohort study received either direct oral feeding (intervention group) after a MIE with intrathoracic anastomosis or nil-by-mouth for 5 days postoperative and tube feeding (standard of care). Primary outcome was time to functional recovery—defined as adequate pain control with oral analgesics, recovery of mobility, sufficient caloric intake, no intravenous fluid therapy and no signs of active infection—and length of hospital stay. Secondary outcomes included anastomotic leakage, pneumonia, cardiopulmonary complications and other (surgical) complications. Results Baseline characteristics were similar in the intervention (n = 85) and control (n = 111) group. Median time to functional recovery was respectively 7 versus 9 days in the intervention and control group (p &lt; 0.001). Median length of hospital stay was respectively 8 versus 10 days in the intervention and control group (p &lt; 0.001). Thirty-day postoperative complications were significantly lower in the intervention group (p = 0.037). Anastomotic leakage and pneumonia rates did not differ between the intervention and control group (respectively 11.8% vs. 10.8%, p = 0.834; 27.1% vs. 33.3%, p = 0.651). Chyle leakage only occurred in the control group (18.9%, p &lt; 0.001). All other postoperative complications were similar between groups. Conclusion Direct oral feeding in a center with a low postoperative complication rate after a MIE results in a reduced time to functional recovery and a shorter length of hospital stay. Importantly, the 30-day postoperative complication rate was significantly lower in patients directly starting oral feeding.

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