Department of Surgery, All India Institute of Medical Sciences, Jodhpur, India.
Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
World J Surg. 2024 Jul;48(7):1626-1633. doi: 10.1002/wjs.12233. Epub 2024 May 27.
INTRODUCTION: Postoperative Ileus (POI) negatively impacts patient outcomes and increases healthcare costs. Transcutaneous electrical nerve stimulation (TENS) has been found to improve gastrointestinal (GI) motility following abdominal surgery. However, its effectiveness in this context is not well-established. This study was designed to evaluate the role of TENS on the recovery of GI motility after exploratory laparotomy. METHODS: Patients undergoing exploratory laparotomy were randomized in a 1:1 ratio into control (standard treatment alone) and experimental (standard treatment + TENS) arms. TENS was terminated after 6 days or after the passage of stool or stoma movement. The primary outcome was time for the first passage of stool/functioning stoma. Non-passage of stool or nonfunctioning stoma beyond 6 days was labeled as prolonged POI. Patients were monitored until discharge. RESULTS: Median (interquartile range) time to first passage of stool/functioning stoma was 82.6 (49-115) hours in the standard treatment group and 50 (22-70.6) hours in the TENS group [p < 0.001]. Prolonged POI was noted in 11 patients in the standard treatment group (35.5%) and one in the TENS group (3.2%) [p = 0.003]. Postoperative hospital stay was similar in the two groups. CONCLUSION: TENS resulted in early recovery of GI motility by shortening the duration of POI without any improvement in postoperative hospital stay. TRIAL REGISTRATION NUMBER: CTRI/2021/10/037054.
介绍:术后肠梗阻(POI)会对患者的预后产生负面影响,并增加医疗保健成本。经皮神经电刺激(TENS)已被发现可改善腹部手术后的胃肠道(GI)蠕动。然而,其在这方面的有效性尚未得到充分证实。本研究旨在评估 TENS 在剖腹探查术后恢复 GI 蠕动中的作用。
方法:接受剖腹探查术的患者以 1:1 的比例随机分为对照组(仅接受标准治疗)和实验组(标准治疗+TENS)。TENS 在 6 天后停止,或在排便或造口运动后停止。主要结局是首次排便/功能造口的时间。6 天后未排便或造口未功能则标记为 POI 延长。患者被监测至出院。
结果:标准治疗组首次排便/功能造口的中位(四分位距)时间为 82.6(49-115)小时,TENS 组为 50(22-70.6)小时[P<0.001]。标准治疗组有 11 例(35.5%)和 TENS 组有 1 例(3.2%)出现 POI 延长[P=0.003]。两组患者术后住院时间相似。
结论:TENS 通过缩短 POI 的持续时间促进了 GI 蠕动的早期恢复,而没有改善术后住院时间。
临床试验注册号: CTRI/2021/10/037054。
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