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Patient-reported extremity symptoms after robot-assisted laparoscopic cystectomy
Veronica Ramirez Johansson1, Ann-Christin von Vogelsang2,3
1Perioperative Medicine and Intensive Care Function, Karolinska University Hospital, Stockholm, Sweden.
Journal of Clinical Nursing
|January 18, 2019
Summary
Nearly half of patients experience extremity symptoms after robot-assisted laparoscopic cystectomy. Early detection and prevention through improved nursing care and documentation are crucial for patient safety and recovery.
Area of Science:
- Urology
- Surgical Nursing
- Patient Safety
Background:
- Perioperative nursing care is vital for patient safety, particularly regarding positioning during surgery.
- Extremity injuries are a known risk in prolonged surgeries, especially robot-assisted urologic procedures in steep Trendelenburg positions.
- Patient and operative factors increase the risk of extremity injuries.
Purpose of the Study:
- To describe patient-reported extremity symptoms following robot-assisted laparoscopic cystectomy for bladder cancer.
- To assess the prevalence and nature of these symptoms.
- To highlight discrepancies between patient reports and medical documentation.
Main Methods:
- A quantitative prospective observational study adhering to STROBE guidelines.
- Patients were monitored using QuickDASH, LEFS, and a study-specific questionnaire.
- Follow-up assessments occurred 7-10 days post-surgery and monthly for up to six months.
Main Results:
- 46.8% of 94 participants reported extremity symptoms 7-10 days post-surgery.
- Pain, numbness, and weakness were the most common symptoms.
- A significant underreporting of symptoms in patient records was observed (13.6% for pain, 27.5% for other symptoms).
Conclusions:
- A substantial number of patients experience postoperative extremity symptoms after robot-assisted laparoscopic cystectomy.
- Effective perioperative nursing, including follow-ups and evidence-based positioning, is essential for preventing and detecting these complications.
- Accurate documentation and continuous patient monitoring are necessary for timely detection and treatment of extremity injuries.
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