The technique of simultaneous laparoscopic operations in the treatment of gallstone disease and hiatal hernia


  • M. Halei
  • I. Dzubanovskij
  • I. Marchuk
Keywords: surgery, laparoscopy, simultaneous surgery, hiatal hernia, gallstone disease.

Abstract

Annotation. Aim of work – to evaluate the quality of medical aid for the regular and simultaneous treatment of patients with gallstone disease in combination with a hiatal hernia. To evaluate the safety of simultaneous operations in the treatment of such patients. Determine advantages and disadvantages of both treatment strategies. Assess the ergonomics of laparoscopic surgery techniques. For sampling the database, statistic collected at the laparoscopic surgery unit of the Volynian Regional Clinical Hospital was used. The number of patients was 332. Patients were formed into two groups: the group of simultaneous laparoscopic treatment (laparoscopic cruroraphy with Toupet fundoplication and laparoscopic cholecystectomy with advanced surgery technique) – the first group of 126 people, and the group with only one operation (laparoscopic cruroraphy) was performed – the second group of 206 patients. The method that was chosen in first group (simultaneous laparoscopic treatment with advanced technique) allowed to prevent re-hospitalization, one more operation, and all associated risks (surgical, anesthesiologycal). Though the cost was a slight increased time of surgery (52 minutes versus 41), as well as a slightly increased the average hospital stay (3.25 days versus 3.1 days) comparing to a single surgery group. Complication rate didn`t increased significantly (5.5% in the first group versus 6.3% in the second group), with zero mortality in both groups. These data allow us to notice the safety and value of this treatment method and to continue its research and testing. The method can be linked to increasing the efficiency of medical care by reducing the number of hospitalizations, the total hospital stay, and reducing the overall cost of treatment, minimizing the cost of dealing with the complications.

References

1. Bloom, A. A., B. S. Anand (Ed.). (2019). Cholecystitis. Emedicine. Medscape /article – 171886. Retrieved from https://emedicine.medscape.com/article/171886-overview

2. Baum, P., Diers, J., Lichthardt, S., Kastner, C., Schlegel, N., Germer, C., & Wiegering, A. (2019). Mortality and Complications Following Visceral Surgery. Dtsch Arztebl Int., 116, 739–46. DOI: 10.3238/arztebl.2019.0739

3. Bourassa-Moreau, É., Mac-Thiong, J.-M., Feldman, D. E., Thompson, C., & Parent, S. (2013). Complications in Acute Phase Hospitalization of Traumatic Spinal Cord Injury: Does Surgical Timing Matter? Trauma Acute Care Surg., 74 (3), 849–54. DOI: 10.1097/TA.0b013e31827e1381

4. Chiu Herng-Chia, Yi-Chieh Lin, Hui-Min Hsieh, Hsin-Pao Chen, Hui-Li Wang, & Jaw-Yuan Wang (2017). The impact of complications on prolonged length of hospital stay after resection in colorectal cancer: A retrospective study of Taiwanese patients. J. Int. Med. Res., 45 (2), 691–705. doi: 10.1177/0300060516684087

5. Dasari, B. V. M., Tan, C. J., Gurusamy, K. S., Martin, D. J., Kirk, G., McKie, L., … Taylor, M. A. (2013). Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst. Rev., 3 (9), CD003327. doi: 10.1002/14651858.CD003327.pub3

6. Deatrich, K. G., & Boyer, B. A. (2016). Post-Traumatic Stress Disorder Related to Surgery: Prevalence and Risk Factors. In: Martin, C., & Preedy, V., & Patel, V. (Eds), Comprehensive Guide to Post-Traumatic Stress Disorders (pp. 351–366). Springer, Cham. https://doi.org/10.1007/978-3-319-08359-9_42

7. Desborough, J. P. (2000). The stress response to trauma and surgery. BJA: British Journal of Anaesthesia, 85 (1), 109–117. https://doi.org/10.1093/bja/85.1.109

8. Di Luzio, R., Dusi, R., Mazzotti, A., Petroni, M. L., Marchesini, G., & Bianchi, G. (2020). Stress Hyperglycemia and Complications Following Traumatic Injuries in Individuals With/Without Diabetes: The Case of Orthopedic Surgery. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 9–17. https://doi.org/10.2147/DMSO.S225796

9. Heuman, D. M., & Mihas, A. A. (2019). Gallstones (Cholelithiasis). Retrieved from https://emedicine.medscape.com/article/175667-overview

10. Fjeld, O. R., Grøvle, L., Helgeland, J., Småstuen, M. C., Solberg, T. K., Zwart, J-A., & Grotle, M. (2019). Complications, reoperations, readmissions, and length of hospital stay in 34 639 surgical cases. Bone Joint Journal, 101-B, (4), 470–477. https://doi.org/10.1302/0301-620X.101B4.BJJ-2018-1184.R14.

11. Hu, J., Feng, X., Valdearcos, M., Lutrin, D., Uchida, Y., Koliwad, S. K., & Maze, M. (2018). Interleukin-6 is both necessary and sufficient to produce perioperative neurocognitive disorder in mice. British Journal of Anaesthesia, 120 (3), 537–545. doi: 10.1016/j.bja.2017.11.096

12. Imamura, K., & Black, N. (1998). Does comorbidity affect the outcome of surgery? International Journal for Quality in Health Care, 10 (2), 113–123. Retrieved from https://academic.oup.com/intqhc/article/10/2/113/1789727

13. Ingeman, A., Andersen, G., Hundborg, H. H., Svendsen, M. L., & Johnsen, S. P. (2011). In-hospital Medical Complications, length of stay, and mortality among stroke unit patients. Stroke, 42 (11), 3214–8. doi: 10.1161/STROKEAHA.110.610881

14. Jerry, J., Upfill-Brown, A., Dann A. M., Kim, S. S., Girgis, M. D., King, J. C., & Donahue, T. R. (2019). Association of Hospital Length of Stay and Complications With Readmission After Open Pancreaticoduodenectomy. JAMA Surg., 154 (1), 88–90. doi: 10.1001/jamasurg.2018.3213

15. Kehlet, H., Jensen, T. S., & Woolf, C. J. (2006). Persistent postsurgical pain: risk factors and prevention. The Lancet, 367 (9522), 1618–1625. https://doi.org/10.1016/S0140-6736(06)68700-X

16. Kerr, D. J., Haller, D. G., van de Velde, C. J. H., & Baumann, M. (Eds), (2016). Oxford Textbook of Oncology. (pp. 362-381). Oxford. Retrieved from https://global.oup.com/academic/product/oxford-textbook-of-oncology-9780199656103?cc=ua&lang=en&

17. Sánchez‐Margallo, F. M., & Sánchez‐Margallo, J. A. (2017). Ergonomics in Laparoscopic Surgery. doi: 10.5772/66170

18. Melloul, E., Hübner, M., Scott, M., Snowden, C., Prentis, J., Dejong, C. H. C., … & Nicolas Demartines (2016). Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations. World Journal of Surgery, 40 (10), 2425–2440. doi: 10.1007/s00268-016-3700-1

19. Mehta, H. B., Dimou, F., Adhikari, D., Tamirisa, N. P., Sieloff, E., Williams, T. P., … & Riall, T. S. (2016). Comparison of Comorbidity Scores in Predicting Surgical Outcomes. Med. Care, 54 (2), 180–187. doi: 10.1097/MLR.0000000000000465

20. Munoz, R. A., ‎Morell, V. O., ‎da Cruz, E. M., Vetterly, C., & da Silva, J. P. (Eds.), (2020). Critical Care of Children with Heart Disease. Basic Medical and Surgical Concepts. ISBN 978-3-030-21870-6

21. Lixin, O., Chen, J., Assareh, H., Hollis, S. J., Hillman, K., & Flabouris, A. (2014). Trends and Variations in the Rates of Hospital Complications, Failure-to-Rescue and 30-Day Mortality in Surgical Patients in New South Wales, Australia, 2002-2009. PLOS ONE, 9 (5), e96164. doi: 10.1371/journal.pone.0096164

22. Parivallal, D. (2019). Task Analysis Of Baseball Diamond Concept For Port Position In Laparoscopy. General Surgery. Retrieved from https://www.laparoscopyhospital.com/task/preview.php?pid=73&p=

23. Scott, M. J., Baldini, G., Fearon, K. C. H., Feldheiser, A., Feldman, L. S., Gan, T. J., … Carli, F. (2015). Enhanced Recovery After Surgery (ERAS ) for gastrointestinal surgery, part 1 pathophysiological considerations. Acta Anaesthesiol Scand, 59 (10), 1212–1231. https://doi.org/10.1111/aas.12601

24. Schricker, T., & Lattermann, R. (2015). Perioperative Catabolism. Can. J. Anaesth., 62 (2), 182–93. doi: 10.1007/s12630-014-0274-y

25. Wang Chien-Ying, Yu-Sen Lin, Ching Tzao, Hui-Chen Lee, Min-Hsiung Huang, Wen-Hu Hsu, & Han-Shui Hsu (2007). Comparison of Charlson comorbidity index and Kaplan-Feinstein index in patients with stage I lung cancer after surgical resection. European Journal of Cardio-Thoracic Surgery, 32 (6), 877–881. https://doi.org/10.1016/j.ejcts.2007.09.008

26. Weiss, M. E., Costa, L. L., Yakusheva, O., & Bobay, K. L. (2014). Validation of Patient and Nurse Short Forms of the Readiness for Hospital Discharge Scale and Their Relationship to Return to the Hospital. Health Serv. Res., 49 (1), 304–317. doi: 10.1111/1475-6773.12092

27. White, P. F, Kehlet, H., Neal, J. M., Schricker, T., Carr, D. B., & Carli, F. (2007). The Role of the Anesthesiologist in Fast-Track Surgery: From Multimodal Analgesia to Perioperative Medical Care. Anesth. & Analg., 104 (6), 1380–96. DOI: 10.1213/01.ane.0000263034.96885.e1

28. Yamashita, Y., Takada, T., Kawarada, Y., Nimura, Y., Hirota, M., Miura, F., … Sachakul, V. (2007). Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines. J. Hepatobiliary Pancreat. Surg., 14 (1), 91–97. doi: 10.1007/s00534-006-1161-x
Published
2020-10-12
How to Cite
Halei, M., Dzubanovskij, I., & Marchuk, I. (2020). The technique of simultaneous laparoscopic operations in the treatment of gallstone disease and hiatal hernia. Reports of Vinnytsia National Medical University, 24(2), 279-285. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2020-24(2)-14