在神经缩术后休息还是不休息? 在ERAS时代消除一个古老的习俗
Andrea Morciano1,2, Giovanni Pecorella3, Andrea Tinelli3
1Department of Gynaecology and Obstetrics, Panico Pelvic Floor Center, Pia Fondazione "Card. G. Panico", Tricase, Lecce, Italy. drmorciano@gmail.com.
Archives of gynecology and obstetrics
|January 20, 2025
概括
在腹腔镜阴道内术 (LSC) 后,中度至高度的体力活动并没有对解剖结果产生负面影响. 与活动水平较低的患者相比,参与较高的活动水平的患者在两年随访时表现出相似的成功率和并发症概况.
科学领域:
- 泌尿和妇科 泌尿和妇科
- 术后恢复 术后恢复
- 盆地底疾病 盆地底疾病
背景情况:
- 泌尿外科手术的传统术后建议往往强调休息和活动限制.
- 手术后增强恢复 (ERAS) 计划旨在优化手术恢复,但对泌尿外科手术后体力活动的具体指导方针仍在争论中.
- laparoscopic sacral colpopexy (LSC) 是一个常见的骨盆器官脱落的程序,恢复方案在外科医生之间有所不同.
研究的目的:
- 评估中度至高度体力活动对LSC后解剖成功的影响.
- 评估经过LSC的患者的长期 (2年) 解剖学和主观结果,以及不同程度的手术后体力活动.
- 挑战传统的建议,在泌尿外科手术后严格在家休息.
主要方法:
- 在2019年10月至2022年2月期间,对201名患者进行了为盆腔缩而进行LSC的回顾性分析.
- 患者在手术后3,6个月和24个月被评估.
- 身体活动水平在3个月后使用国际身体活动问卷简单表格 (IPAQ-SF) 评估,将患者分为低活动和中等高活动组.
主要成果:
- 3个月后观察到高解剖学成功率,低和中等高活动群体之间没有统计学上显著的差异.
- 这些积极的解剖结果在6个月和24个月的随访中持续存在.
- 在任何随访点上,活动组之间没有发现主观成功率或阴道网侵蚀发生率的显著差异.
结论:
- 在LSC后,中度至高水平的体力活动水平与不良解剖结果或增加的并发症无关.
- 该研究表明,需要重新评估传统的手术后休息建议,并专注于患者在LSC后体育活动方面的教育.
- 鼓励适当的体力活动可能对接受LSC的患者的康复和长期结果有益.
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