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腹腔镜袖状胃切除术随访:术后使用连接装置。

Laparoscopic sleeve gastrectomy follow-up: use of connected devices in the postoperative period.

机构信息

ELSAN, Clinique Saint Michel, Centre Chirurgical de l'Obesité (CCO), 83100 Toulon, France.

ELSAN, Clinique Saint Michel, Centre Chirurgical de l'Obesité (CCO), 83100 Toulon, France.

出版信息

Surg Obes Relat Dis. 2019 Jul;15(7):1058-1065. doi: 10.1016/j.soard.2019.03.033. Epub 2019 Apr 5.

Abstract

BACKGROUND

During the last decade, laparoscopic sleeve gastrectomy (LSG) has become the most performed bariatric procedure worldwide.

OBJECTIVES

To evaluate the feasibility of the use of connected devices in monitoring patients operated on by LSG and discharged 24 hours after surgery under the enhanced recovery after surgery protocol.

SETTING

Private hospital, France.

METHODS

This is a prospective pilot study designed to assess the risk and benefit of using connected devices in the postoperative follow-up of patients operated on by LSG. Patients operated on with LSG were discharged 24 hours after surgery, and vital signs such as blood pressure, heart rate, peripheral capillary oxygen saturation, and temperature were monitored via connected devices with data sent to an internet platform to make them immediately viewable by the surgeon.

RESULTS

The study population consisted of 82 women and 18 men. The mean body mass index was 43.4 kg/m, and the mean age was 39.6 years. Two patients were reoperated on for bleeding and, consequently, were excluded from the study. At postoperative day 8, 1 patient presented with tachycardia, fever, and mild abdominal discomfort. After the alert was received from the internet platform, the patient was immediately contacted, admitted to the ward, and promptly reoperated on. At 1 year after the surgery, the mean percentage of excess weight loss and total weight loss were 68.1 ± 18.1% and 36 ± 9.8 kg, respectively. For the patients not available for follow-up at the 1-year control, weight loss data were extrapolated from the internet platform. Globally, 92% of patients felt safe when they returned home, and 92% of patients would recommend this way of managing the postoperative period.

CONCLUSIONS

In conclusion, this study shows that the early postoperative follow-up to an intervention such as LSG can be done at the patient's home under the monitoring of connected devices without a risk of increase in the rate of complications and rehospitalization. The role of the connected devices in the long-term postoperative follow-up seems promising.

摘要

背景

在过去十年中,腹腔镜袖状胃切除术(LSG)已成为全球开展最多的减重手术。

目的

评估在术后快速康复方案下,使用连接设备监测 LSG 术后 24 小时出院患者的可行性。

地点

法国私立医院。

方法

这是一项前瞻性试点研究,旨在评估在 LSG 术后患者的随访中使用连接设备的风险和获益。接受 LSG 手术的患者在术后 24 小时出院,通过连接设备监测生命体征,如血压、心率、外周毛细血管血氧饱和度和体温,并将数据发送到互联网平台,以便外科医生即时查看。

结果

研究人群包括 82 名女性和 18 名男性。平均体重指数为 43.4kg/m²,平均年龄为 39.6 岁。2 名患者因出血再次手术,因此被排除在研究之外。术后第 8 天,1 名患者出现心动过速、发热和轻度腹部不适。从互联网平台收到警报后,立即与患者联系,将其收治入院并立即再次手术。术后 1 年,超重体重减轻和总体重减轻的平均百分比分别为 68.1%±18.1%和 36±9.8kg。对于在 1 年随访时无法进行随访的患者,体重减轻数据从互联网平台推断得出。总体而言,92%的患者在回家时感到安全,92%的患者会推荐这种管理术后期的方式。

结论

总之,这项研究表明,在连接设备的监测下,LSG 等干预措施的早期术后随访可以在患者家中进行,而不会增加并发症和再住院的风险。连接设备在长期术后随访中的作用似乎很有前景。

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