Eidy Mohammad, Jesmi Fatemeh, Raygan Fahimeh, Pishgahroudsari Mohadeseh, Pazouki Abdolreza
Fellowship of Laparoscopy, Kashan University of Medical Sciences , Kashan, Iran . ; Minimally Invasive Surgery Research Center, Iran University of Medical Sciences , Tehran, Iran .
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences , Tehran, Iran .
Bariatr Surg Pract Patient Care. 2015 Mar 1;10(1):38-41. doi: 10.1089/bari.2014.0032.
Most morbidly obese patients complain of abdominal pain after laparoscopic gastric bypass (LGBP) surgery. In this study, the relationship between the prevalence and severity of pain and the drain site was assessed. Fifty morbidly obese patients undergoing LGBP surgery were selected, and a drain was randomly inserted postoperatively to the left 5 mm port in 25 cases and to the right in the other 25. All patients filled out a questionnaire, including a visual analog scale for the quality and quantity of pain, exacerbating and alleviating factors and its relation to patient's positioning, in the first 24 hours, first week, and first month after the operation. In both groups, all patients had abdominal pain 24 hours after the operation. However, in the right-sided drain group, most patients (52%) experienced mild pain, whereas most patients (56%) in the left-sided drain group had severe pain (=0.028). At weeks 1 and 4, there was no significant difference between the two groups in terms of severity of pain (=0.068 and 0.875, respectively, for both times). After the first 24 hours and first week, the mean pain score was significantly lower in the right-sited drain group compared to the left-sited drain group (=0.012 and 0.006). Early abdominal pain after LGBP surgery is significantly reduced in the right-sided drain group.
大多数病态肥胖患者在腹腔镜胃旁路术(LGBP)后会抱怨腹痛。在本研究中,评估了疼痛的发生率、严重程度与引流部位之间的关系。选择了50例行LGBP手术的病态肥胖患者,术后随机在25例患者的左侧5毫米端口插入引流管,另外25例插入右侧。所有患者在术后第1个24小时、第1周和第1个月填写问卷,包括疼痛的性质和程度、加重和缓解因素及其与患者体位的关系的视觉模拟量表。两组患者术后24小时均有腹痛。然而,右侧引流管组的大多数患者(52%)经历轻度疼痛,而左侧引流管组的大多数患者(56%)有重度疼痛(=0.028)。在第1周和第4周,两组在疼痛严重程度方面无显著差异(两次分别为=0.068和0.875)。在术后第1个24小时和第1周后,右侧引流管组的平均疼痛评分显著低于左侧引流管组(=0.012和0.006)。LGBP术后早期腹痛在右侧引流管组明显减轻。