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Perioperatives Management bei laparoskopischer Operation primärer und sekundärer Bauchdeckenhernien in der Mittellinie

  • Juliane Bingener
  • Ralf Wilke

Zusammenfassung

Dieses Kapitel beschreibt die Anwendung der Komponenten der „enhanced recovery after surgery“ (ERAS) auf die laparoskopische ventrale Hernienreparatur. Es ist wichtig, die Patienten vor der Operation sorgfältig über die Komponenten eines ERAS/Fast track-Programms aufzuklären und das gesamte perioperative Team mit einzubeziehen. Nur so kann der verkürzte Behandlungspfad erfolgreich zu sein. Die Aufklärung über die multimodale perioperative Schmerzkontrolle ist ein wichtiger Teil der präoperativen Evaluation. Die Reduktion von Narkotika durch Acetaminophen/Paracetamol, Lokalanästhetika und nicht steroidale entzündungshemmende Medikamente, angemessene Hydratisierung, die frühe postoperative orale Nahrungsaufnahme sowie eine rasche Mobilisation sind die entscheidenden Faktoren für die postoperative Erholung.

Literatur

  1. Aarts MA, Okrainec A, Glicksman A, Pearsall E, Victor JC, McLeod RS (2012) Adoption of enhanced recovery after surgery (ERAS) strategies for colorectal surgery at academic teaching hospitals and impact on total length of hospital stay. Surg Endosc 26 (2): 442–50CrossRefPubMedGoogle Scholar
  2. Andersen HK, Lewis SJ, Thomas S (2006) Early enteral nutrition within 24h of colorectal surgery versus later commencement of feeding for postoperative complications. Cochrane Database Syst Rev 4: CD004080Google Scholar
  3. Awad S, Varadhan KK, Ljungqvist O, Lobo DN (2013) A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery. Clin Nutr 32 (1): 34–44CrossRefPubMedGoogle Scholar
  4. Basse L, Madsen JL, Kehlet H (2001) Normal gastrointestinal transit after colonic resection using epidural analgesia, enforced oral nutrition and laxative. Br J Surg 88 (11): 1498–500CrossRefPubMedGoogle Scholar
  5. Bellows CF, Berger DH (2006) Infiltration of suture sites with local anesthesia for management of pain following laparoscopic ventral hernia repairs: a prospective randomized trial. JSLS 10 (3): 345–50Google Scholar
  6. Christoffersen MW, Olsen BH, Rosenberg J, Bisgaard T (2015) Randomized clinical trial on the postoperative use of an abdominal binder after laparoscopic umbilical and epigastric hernia repair. Hernia 19 (1): 147–53CrossRefPubMedGoogle Scholar
  7. Dervenis C, Avgerinos C, Lytras D, Delis S (2003) Benefits and limitations of enteral nutrition in the early postoperative period. Langenbecks Arch Surg 387 (11–12): 441–9Google Scholar
  8. Eriksen JR, Poornoroozy P, Jorgensen LN, Jacobsen B, Friis-Andersen HU, Rosenberg J (2009) Pain, quality of life and recovery after laparoscopic ventral hernia repair. Hernia 13 (1): 13–21CrossRefPubMedGoogle Scholar
  9. Fields AC, Gonzalez DO, Chin EH, Nguyen SQ, Zhang LP, Divino CM (2015) Laparoscopic-assisted transversus abdominis plane block for postoperative pain control in laparoscopic ventral hernia repair: a randomized controlled trial. J Am Coll Surg 221 (2): 462–9CrossRefPubMedGoogle Scholar
  10. Gillissen F, Hoff C, Maessen JM, Winkens B, Teeuwen JH, von Meyenfeldt MF, Dejong CH (2013) Structured synchronous implementation of an enhanced recovery program in elective colonic surgery in 33 hospitals in The Netherlands. World J Surg 37 (5): 1082–93CrossRefPubMedGoogle Scholar
  11. Gough AE, Chang S, Reddy S, Ferrigno L, Zerey M, Grotts J, Yim S, Thoman SD (2015) Periprosthetic anesthetic for postoperative pain after laparoscopic ventral hernia repair: a randomized clinical trial. JAMA Surg 150 (9): 835–40CrossRefPubMedGoogle Scholar
  12. Han-Geurts IJ, Hop WC, Kok NF, Lim A, Brouwer KJ, Jeekel J (2007) Randomized clinical trial of the impact of early enteral feeding on postoperative ileus and recovery. Br J Surg 94 (5): 555–61CrossRefPubMedGoogle Scholar
  13. Hoffmann H, Kettelhack C (2012) Fast-track surgery – conditions and challenges in postsurgical treatment: a review of elements of translational research in enhanced recovery after surgery. Eur Surg Res 49 (1): 24–34CrossRefPubMedGoogle Scholar
  14. Kehlet H, Mogensen T (1999) Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. Br J Surg 86 (2): 227–30CrossRefPubMedGoogle Scholar
  15. Leonard J, Hieken TJ, Hussein M, Harmsen WS, Sawyer M, Osborn J, Bingener J (2016) Delineation of factors associated with prolonged length of stay after laparoscopic ventral hernia repair leads to a clinical pathway and improves quality of care. Surg Endosc 30 (4): 1614–8CrossRefPubMedPubMedCentralGoogle Scholar
  16. Lewis SJ, Egger M, Sylvester PA, Thomas S (2001) Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ 323 (7316): 773–6CrossRefPubMedPubMedCentralGoogle Scholar
  17. McLeod RS, Aarts MA, Chung F, Eskicioglu C, Forbes SS, Conn LG, McCluskey S, McKenzie M, Morningstar B, Nadler A, Okrainec A, Pearsall EA, Sawyer J, Siddique N, Wood T (2015) Development of an enhanced recovery after surgery guideline and implementation strategy based on the knowledge-to-action cycle. Ann Surg 262 (6): 1016–25CrossRefPubMedGoogle Scholar
  18. Mitchell A, van Zanten SV, Inglis K, Porter G (2008) A randomized controlled trial comparing acetaminophen plus ibuprofen versus acetaminophen plus codeine plus caffeine after outpatient general surgery. J Am Coll Surg 206 (3): 472–9CrossRefPubMedGoogle Scholar
  19. Nadler A, Pearsall EA, Victor JC, Aarts MA, Okrainec A, McLeod RS (2014) Understanding surgical residents’ postoperative practices and barriers and enablers to the implementation of an Enhanced Recovery After Surgery (ERAS) Guideline. J Surg Educ 71 (4): 632–8CrossRefPubMedGoogle Scholar
  20. Nelson R, Edwards S, Tse B (2007) Prophylactic nasogastric decompression after abdominal surgery. Cochrane Database Syst Rev 3: CD004929Google Scholar
  21. Nygren J, Soop M, Thorell A, Efendic S, Nair KS, Ljungqvist O (1998) Preoperative oral carbohydrate administration reduces postoperative insulin resistance. Clin Nutr 17 (2): 65–71CrossRefPubMedGoogle Scholar
  22. Rawal N (2016) Current issues in postoperative pain management. Eur J Anaesthesiol 33 (3): 160–71CrossRefPubMedGoogle Scholar
  23. Rothman JP, Gunnarsson U, Bisgaard T (2014) Abdominal binders may reduce pain and improve physical function after major abdominal surgery – a systematic review. Dan Med J 61 (11): A4941Google Scholar
  24. Saber AA, Elgamal MH, Rao AJ, Itawi EA, Martinez RL (2009) Early experience with lidocaine patch for postoperative pain control after laparoscopic ventral hernia repair. Int J Surg 7 (1): 36–8CrossRefPubMedGoogle Scholar
  25. Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J (2014) Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev 8: CD009161Google Scholar
  26. Steenhagen E (2016) Enhanced recovery after surgery: It’s time to change practice! Nutr Clin Pract 31 (1): 18–29CrossRefPubMedGoogle Scholar
  27. Torgersen Z, Balters M (2015) Perioperative nutrition. Surg Clin North Am 95 (2): 255–67CrossRefPubMedGoogle Scholar
  28. Wang ZG, Wang Q, Wang WJ, Qin HL (2010) Randomized clinical trial to compare the effects of preoperative oral carbohydrate versus placebo on insulin resistance after colorectal surgery. Br J Surg 97 (3): 317–27CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Deutschland 2018

Authors and Affiliations

  • Juliane Bingener
    • 1
  • Ralf Wilke
    • 2
  1. 1.Department of SurgeryMayo ClinicRochesterUSA
  2. 2.Klinik für Allgemein-, Viszeral- und Gefäßchirurgie; Klinik NagoldKreisklinikum Calw-NagoldNagoldDeutschland

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