50 research outputs found
Laparoskopinė storosios žarnos chirurgija: pirmoji patirtis Lietuvoje
No full textGintarė Valeikaitė1, Juozas Stanaitis2, Nerijus Kaselis3, Eligijus Poškus4, Kęstutis Strupas4, Dainius Pavalkis1
1 Kauno medicinos universiteto klinikų Chirurgijos klinika;
2 Vilniaus universiteto Bendrosios ir plastinės chirurgijos, ortopedijos ir traumatologijos klinika;
3 Klaipėdos apskrities ligoninės Chirurgijos skyrius;
4 Vilniaus universiteto ligoninės Santariškių klinikų Pilvo chirurgijos centras,
Santariškių g. 2, LT-08661 Vilnius
El paštas: [email protected]
Įvadas
Šio straipsnio tikslas – įvertinti pirmąją laparoskopinės storosios žarnos chirurgijos praktiką Lietuvoje ir supažindinti su pasauline patirtimi.
Metodai
Sudarytas klausimynas išsiųstas keturiems pagrindiniams Lietuvos centrams, kuriuose atliekamos storosios žarnos laparoskopinės operacijos. Išnagrinėti 56 atliktų operacijų duomenys. Trisdešimt šeši (64,3%) pacientai buvo operuoti nuo vėžio: penkiolika – nuo riestinės, vienuolika – tiesiosios, keturi – kylančiosios, trys – aklosios, du – skersinės ir vienas – nusileidžiančiosios žarnos vėžio. Nuo nepiktybinių storosios ir tiesiosios žarnos ligų operuota dvidešimt (35,7%) pacientų: aštuoni – nuo divertikuliozės, aštuoni – tiesiosios žarnos iškritimo, keturi – pailgėjusios riestinės žarnos. Vidutinis moterų amžius – 64,9 metų, vyrų – 59,7 metų.
Rezultatai
Buvo atlikta septyniolika aukštų priekinių tiesiosios žarnos rezekcijų, vidutinė operacijos trukmė (VOT) – 203,9 min., penkiolika dešinių hemikolektomijų, VOT – 212 min., devynios kairios hemikolektomijos, VOT – 221,4 min., šešios riestinės žarnos rezekcijos, VOT – 194 min., trys riestinės ir tiesiosios žarnos rezekcijos, VOT – 220 min, aštuonios rektopeksijos, VOT – 179,5 min., viena tiesiosios žarnos ekstirpacija, VOT – 255 min. Visos žarnų jungtys buvo padarytos intrakorporaliniu būdu, išskyrus dešinę hemikolektomiją, kai jungtis padaroma išorėje per minilaparotominį pjūvį dešinėje pilvo sienos pusėje. Konversijos priežastys dviem atvejais buvo kraujavimas iš pasaito ir dviem atvejais – peraugęs į gretimus organus navikas. Vidutiniškai prieš operaciją ligoniai gulėjo 3,2 dienos, po operacijos – 8,3 dienos.
Išvada
Laparoskopinis metodas toliau vertinamas atliekant perspektyvųjį nacio nalinį tyrimą.
Reikšminiai žodžiai: laparoskopija, storoji žarna, chirurgija
First experience in laparoscopic colorectal surgery in Lithuania
Gintarė Valeikaitė1, Juozas Stanaitis2, Nerijus Kaselis3, Eligijus Poškus4, Kęstutis Strupas4, Dainius Pavalkis1
1 Kaunas University of Medicine, Clinic of Surgery;
2 Vilnius University Clinic of General, Plastic Surgery, Orthopedic and Traumatology;
3 Klaipėda City Hospital;
4 Vilnius University Hospital Santariškių Klinikos, Centre of Abdominal Surgery,
Santariškių 2, LT-08661 Vilnius, Lithuania
E-mail: [email protected]
Objective
To evaluate the first experience in laparoscopic colorectal surgery in Lithuania and to review the worldwild accepted practice.
Methods
A questionnaire was sent to four major centers performing laparoscopic colorectal surgery in Lithuania. Analysis of obtained data showed that 56 laparoscopic operations were performed. For colorectal cancer were operated 36 patients (64.3%): 11 for rectal, 15 for sigmoid, 4 for ascending colon, 3 for ceacal, 2 for transversal and 1 for descending colon cancer. For benign colorectal disease – 20 (35.7%): 8 for diverticular disease, 8 for rectal prolapse, 4 for constipation caused by sigmoid elongation. The mean age of males was 59.7 and of females – 64.9 years.
Results
There were performed 15 laparoscopic left hemicolectomies (the mean operative time (MOT) 212 min), 17 laparoscopic high rectal resections (MOT 203.9 min), 9 laparoscopic right hemicolectomies (MOT 221.4 min), 6 sigmoid resections (MOT 194 min), 3 sigmoid and rectal resections (MOT 220 min), 8 laparoscopic rectopexies (MOT 179.5 min) and one laparoscopic abdominoperineal resection, operative time 255 min. All the anastomoses were intracorporeal, except right hemicolectomies and sigmoid resections. The reasons for conversion were bleeding from mesenterium in 2 cases and advanced tumours in 2 cases. The mean preoperative stay was 3.2 and postoperative stay 8.3 days.
Conclusions
There could not be clear conclusions, and the laparoscopic method is being further evaluated by a prospective national trial.
Key words: laparoscopic colorectal surger
ELEKTRONINIS POSŪKIS: NUO FIZINIO MIESTO LINK E-TOPOS MIESTO
No full textStraipsnyje nagrinėjamas „elektroninis posūkis“, kuris akivaizdžiai pastebimas filosofinėje urbanistinių temų analizėje. Greta neutralaus miesto topos aprašymo, utopinių ir distopinių miesto vizijų susiformuoja teorinis diskursas, aprašantis miestą per e-topos prizmę. Naujasis diskursas filosofinėje miesto analizėje akcentuoja medijų poveikio miesto funkcionavimui bei globalizacijos procesų komponentą. Atskleidžiama, kaip „elektroninis posūkis“ pakeitė miestiečio, namų ir miesto erdvių interpretacijas. Parodoma, jog „elektroninio posūkio“ teorijose miestiečio sąmoningumas siejamas su skaitmeniniais nervų sistemos parametrais, namai aprašomi kaip komunikacijos tinklais su pasauliu sujungti atviri dariniai, o miestas suprantamas ne per fizines struktūras, bet per dinamiškas srautų erdves.
Pagrindiniai žodžiai: miestas, e-topos, srautų erdvė.
Electronic Turn: From Physical City towards e-topos City
Nerijus Milerius
Summary
The author deals with the “electronic turn” which is evidently present in philosophical analysis of urban subjects. As the effect of such turn, along with three traditional theoretical discourses, neutral descriptive analysis of the urban topos, utopias and dystopias, a new urban discourse of e-topos has been establishing itself. The new urban discourse lays stress on the outcomes of the media and the processes of globalization for the city life and its structures. In the artic le, an essential shift in the interpretation of citizen, home and urban spaces is revealed. Theories contributing to “electronic turn” analyze urban citizen through the prism of digital parameters of the nervous system, describe the home as the open units integrated into the communication network, reveal the city not through its material structures, but through the dynamic space of flows.
Keywords: city, e-topos, space of flows.
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Shouldice, Lichtensteino ir laparoskopinių transabdominalinių preperitoninių kirkšninių išvaržų operacijų ankstyvieji rezultatai
No full textVytautas Lipnickas1, Mindaugas Kiudelis2, Andrius Gradauskas3, Nerijus Kaselis4, Kęstutis Strupas1
1 Vilniaus universiteto ligoninės Santariškių klinikų Pilvo chirurgijos centras,
Santariškių g. 2, LT-08661 Vilnius;
2 Kauno medicinos universiteto klinikų Chirurgijos klinika;
3 Vilniaus miesto universitetinė ligoninė;
4 Klaipėdos miesto ligoninė
El paštas: [email protected]
Įvadas / tikslas
Kirkšninių išvaržų chirurginio gydymo būdų yra daug. Kuris geriausias – nėra aišku. Lietuvoje atlikta pirmoji daugiacentrė perspektyvioji atsitiktinių imčių klinikinė studija. Šio straipsnio tikslas – pateikti minėtos studijos, kurioje palygintos Shouldice, Lichtensteino ir laparoskopinės TAPP kirkšninių išvaržų operacijos, ankstyvuosius rezultatus.
Ligoniai ir metodai
2003 metų sausio–gruodžio mėnesiais keturiose Lietuvos ligoninėse pagal Lietuvos bioetikos komiteto patvirtintą daugiacentrės perspektyviosios atsitiktinių imčių klinikinės studijos protokolą buvo operuoti 248 ligoniai. Operacijos atliktos pagal standartizuotus Shouldice, Lichtensteino ir laparoskopinės TAPP kirkšninių išvaržų operacijų protokolus.
Rezultatai
Ankstyvieji studijos rezultatai parodė, kad visos operacijos yra saugios. Statistiškai reikšmingas skirtumas gautas vertinant operacijos trukmę bei hospitalizacijos laiką – laparoskopinės TAPP operacijos trunka statistiškai reikšmingai ilgiau nei atvirosios, tačiau po laparoskopinių operacijų hospitalizacijos laikas yra statistiškai reikšmingai trumpesnis (p = 0,026 lyginant laparoskopines ir Lichtensteino operacijas). Ankstyvas pooperacinis skausmas statistiškai reikšmingai mažesnis (p < 0,05 po 8 val., p < 0,01 po 24 val.) buvo po laparoskopinių operacijų. Praėjus dviem savaitėms skausmą operacijos vietoje nurodė 36 (42,3%) pacientai po Shouldice operacijos, 23 (28,4%) – po Lichtensteino ir tik 2 (2,4%) – po laparoskopinės TAPP operacijos, o jokių skundų neturėjo atitinkamai 38 (44,7%), 45 (55,6%) ir 63 (76,8%) ligoniai.
Išvados
Laparoskopinė TAPP operacija yra mažiausią skausmą sukelianti ir labiausiai ligoniui patogi operacija; be to, po šios operacijos hospitalizacijos laikas yra trumpiausias. Tačiau operacija trunka statistiškai reikšmingai ilgiau ir jai atlikti reikia bendrinės nejautros.
Reikšminiai žodžiai: kirkšninė išvarža, transabdominalinė preperitoninė (TAPP) hernioplastika, ankstyvieji rezultatai
Early results of Shouldice vs Lichtenstein vs laparoscopic transabdominal preperitoneal inguinal hernia repair: multicenter randomized clinical trial
Vytautas Lipnickas1, Mindaugas Kiudelis2, Andrius Gradauskas3, Nerijus Kaselis4, Kęstutis Strupas1
1 Vilnius University Hospital Santariškių Klinikos, Centre of Abdominal Surgery,
Santariškių 2, LT-08661 Vilnius, Lithuania;
2 Kaunas University of Medicine, Clinic of Surgery;
3 Vilnius City University Hospital;
4 Klaipėda City Hospital
E-mail: [email protected]
Background / objective
Open anterior inguinal hernia repair is a time-tested, safe and well-understood operation with a high success rate, while laparoscopic techniques are fairly recent; their short- and long-term outcomes are still being evaluated, but the best method of inguinal hernia repair is still unclear.
Methods
A prospective randomized multicenter clinical trial was performed in four surgical centers of Lithuania. Patients were operated on from January to December, 2003. Intraoperative, early and late postoperative complications, time of operation, hospital stay, postoperative pain evaluation, frequency of recurrence and changes of quality of life of laparoscopic TAPP (n = 82), Lichtenstein (n = 81) and Shouldice (n = 85) hernia repair were compared.
Results
The mean operative time in the laparoscopic TAPP group was significantly longer than the mean operative time in Lichtenstein and Shouldice hernia repair group. There were no major intraoperative complications and only two postoperative wound infections in the Shouldice and Lichtenstein group. There was no difference in the frequency of minor intraoperative and early postoperative complications in the groups. The mean pain scores in the laparoscopic TAPP group were significantly lower than the corresponding scores in the Lichtenstein and Shouldice group (p < 0.05 at 8 h after operation and p < 0.01 at 24 h after operation). Statistically significant differences were found in hospital stay, the shortest stay being recorded in the laparoscopic TAPP group (p = 0.026 comparing laparoscopic TAPP and Lichtenstein hernia repair). 36 (42.3%) patients in the Shouldice and 23 (28.4%) in the Lichtenstein group felt a moderate or mild pain 2 weeks postoperatively, while there were only 2 (2.4%) patients with a mild pain in the laparoscopic TAPP group. There were 38 (44.7%) patients in the Shouldice group, 45 (55.6%) in Lichtenstein group and 63 (76.8%) patients in laparoscopic TAPP group without any complaint after 2 weeks. There were no recurrences at 2 weeks postoperatively.
Conclusions
The laparoscopic TAPP, Lichtenstein and Shouldice hernia repair are equally safe and have no major intraoperative complications. The laparoscopic TAPP inguinal hernia repair is associated with less postoperative pain and sensitivity disorders, shortest hospital stay, but it requires general anaesthesia and a longer operating time.
Keywords: groin hernia, transabdominal preperitoneal (TAPP) hernioplasty, early result
Shouldice, Lichtensteino ir laparoskopinių TAPP kirkšninių išvaržų operacijų lyginamasis
No full textVytautas Lipnickas1, Mindaugas Kiudelis2, Andrius Gradauskas3, Nerijus Kaselis4, Deividas Narmontas1, Kęstutis Strupas1
1 Vilniaus universiteto ligoninės Santariškių klinikų Pilvo chirurgijos centras,
Santariškių g. 2, LT-08661 Vilnius;
2 Kauno medicinos universiteto klinikų Chirurgijos klinika;
3 Vilniaus miesto universitetinė ligoninė;
4 Klaipėdos miesto ligoninė
El paštas: [email protected]
Įvadas / tikslas
Pacientai, turintys kirkšninę išvaržą, operuojami ir tradiciniais būdais, ir naujesniais, kai operacijos metu naudojami sintetiniai aloplastiniai tinkleliai. Specialistai tebediskutuoja, kuris chirurginio gydymo būdas yra geriausias. Esant panašiems komplikacijų ir recidyvų skaičiams, svarbūs yra visi operacijos poveikio pacientui aspektai. Vienas jų yra gyvenimo kokybės pokyčiai.
Metodai
Perspektyvus daugiacentris atsitiktinių imčių klinikinis tyrimas, lyginantis Shouldice, Lichtensteino ir laparoskopines TAPP operacijas, atliktas 2003–2004 metais keturiose Lietuvos ligoninėse. Pagal standartizuotą metodiką operuoti 248 pacientai. Prieš operaciją užpildytas bendras visų pacientų gyvenimo kokybės klausimynas SF-36. Praėjus po operacijos 2 sav., 6 ir 12 mėn., pacientai buvo kviečiami kontrolinių patikrinimų, per kurios pildyta speciali paciento fizinės būklės vertinimo anketa ir pooperacinis klausimynas SF-36.
Rezultatai
Ankstyvu pooperaciniu laikotarpiu statistiškai reikšmingas skirtumas tarp laparoskopinių ir abiejų atvirųjų operacijų grupių rastas vertinant pagal fizinio funkcionalumo, veiklos apribojimo dėl fizinių problemų, kūno skausmo ir socialinio funkcionalumo skales. Statistiškai reikšmingai mažiau pacientų skundėsi skausmu operacijos vietoje po laparoskopinių operacijų, palyginti su atvirosiomis, p < 0,001. Po 6 mėn. rastas laparoskopinių operacijų ir atvirųjų skirtumas vertinant pagal įprastinės veiklos apribojimo dėl fizinių problemų skalę, p < 0,05. Statistiškai reikšmingas skirtumas buvo tarp laparoskopinių ir abiejų atvirųjų operacijų grupių lėtinio skausmo požiūriu, p < 0,01. Po operacijos praėjus 12 mėn., nė vienos SF-36 sveikatos vertinimo skalės statistiškai reikšmingo skirtumo nenustatyta. Jo nerasta ir vertinant lėtinį skausmą. Lyginant fizinę būklę, statistiškai reikšmingai skyrėsi laparoskopinių ir Shouldice operacijų grupės, p < 0,01.
Išvados
Laparoskopinės TAPP operacijos rezultatai gyvenimo kokybės ir lėtinio skausmo požiūriu tiek ankstyvu, tiek vėlyvu pooperaciniu laikotarpiu yra geriausi. Iš atvirųjų operacijų ankstyvu pooperaciniu laikotarpiu gyvenimo kokybės požiūriu geresni Lichtensteino operacijų grupės rezultatai negu Shouldice operacijų.
Reikšminiai žodžiai: kirkšninė išvarža, gyvenimo kokybė, SF-36, lėtinis skausmas
Randomized multicenter prospective clinical trial of Shouldice vs Lichtenstein vs laparoscopic TAPP inguinal hernia repair: chronic pain and health-related changes of quality of life
Vytautas Lipnickas1, Mindaugas Kiudelis2, Andrius Gradauskas3, Nerijus Kaselis4, Deividas Narmontas1, Kęstutis Strupas1
1 Vilnius University Hospital Santariškių Klinikos, Centre of Abdominal Surgery,
Santariškių 2, LT-08661 Vilnius, Lithuania;
2 Kaunas University of Medicine, Clinic of Surgery;
3 Vilnius City University Hospital;
4 Klaipėda City Hospital
E-mail: [email protected]
Background / objective
Open anterior inguinal hernia repair is a time-tested, safe and well-understood operation with a high success rate, while laparoscopic techniques are fairly recent. However, the best surgical approach to the repair of inguinal hernias is still unclear. Given their similarity in terms of complications and recurrence rate, other issues associated with these surgical techniques become more important. One of them is the quality of life.
Methods
The prospective randomized multicenter clinical study was performed in four surgical centers of Lithuania in 2003. 248 patients were operated on according to standardized protocols of Shouldice, Lichtenstein and laparoscopic TAPP inguinal hernia repairs. Chronic pain and changes of the quality of life according to the SF-36 questionnaire and ad hoc questionnaire of physical status were compared.
Results
The significantly higher scores in the physical functioning, role-physical, bodily pain and social functioning scales for laparoscopic hernia repair at 2 weeks postoperatively were apparent. The laparoscopic group had significantly less pain (p < 0.001). The significantly higher scores in the role-physical scale for laparoscopic to both open hernia repair methods at 6 months after operation were found (p < 0.05). The laparoscopic group had significantly less chronic pain 6 months postoperatively (p < 0.01). No significant difference in quality of life among three methods one year after operation was apparent. The laparoscopic group had less chronic pain one year after operation, but the difference was not significant
Conclusions
The laparoscopic TAPP inguinal hernia repair had the best scores of quality of life both in the early and the late postoperative periods. There was less chronic pain after laparoscopic TAPP inguinal hernia repair. The higher scores of quality of life were recorded after Lichtenstein versus Shouldice inguinal hernia repair in the early postoperative period.
Keywords: groin hernia, health-related quality of life, SF-36, chronic pai
Tributalizmo koncepcija: S. Amino, J. Haldono ir H. H. Stahlio sampratų lyginamoji analizė
No full textBy this article, the author wants to revive discussion about Marxist schemas of social development and their applicability for constructing models of universal history. There are attitudes of three scholars presented in the current text: Samir Amin, who is known in the Western historiographical tradition as a main creator and promoter of the concept of the tributary mode of production; John Haldon, who paid quite much attention to the mentioned concept and dedicated his entire book to this issue; and Henri H. Stahl, who created an original alternative approach to the issue of tributalism.
The author rejects J. Haldon\u27s concept of mode of production as too narrow (in fact, J. Haldon identifies mode of production with mode of exploitation). The author proposes a wider definition of mode of production, which is based on the analysis of Karl Marx\u27s texts. According to the author, the most important elements of mode of production are the exploitative subject (it is defined by property of conditions of production, which realizes as a social power) and productive/obligatory unit, which can be manifested as a household of an individual direct producer or as a community. The author proposes the following principled classification based on his conception of mode of production:
A proprietor of land is a monarch/state, and a productive/obligatory unit is a community (of Asiatic/Slavonic type);
A proprietor of land is a monarch/state, and a productive/obligatory unit is a household of an individual direct producer;
Proprietors of land are private landowners, and a productive/obligatory unit is a community (of Asiatic/Slavonic type);
Proprietors of land are private landowners, and a productive/obligatory unit is a household of an individual direct producer.
The most important conclusions of the author\u27s are as follows:
H. H. Stahl\u27s statement that there were alternatives in the social development of precapitalist societies is definitely reasonable.
Keeping in mind controversies among the presented conceptions of tributalism, the author emphasizes that, at the moment, the question of the typology of antagonistic precapitalist societies remains open; so further researches and discussions are necessary.
As a point of departure for further researches and discussions the author proposes his principled classification of antagonisticprecapitalist societies based on criteria of an exploitative subject and a productive / obligatory unit
Kinematografinė kultūra Lietuvoje, 1926-1944 m.: tarp pramogos ir ideologijos (disertacijos santrauka).
No full textIn 1926-1944, three non-democratic (Lithuanian tautininkai, soviet and Nazi) regimes with different ideologies changed in Lithuania. In this dissertation, author researched and compared such attributes of film culture in Lithuania as: the network of cinemas and its development; repertoire of screened films; film journalism in the country and film reflections in the literary imagination; and film reception. By doing so, the author tried to answer the question: how did the cinema functioned in the country during these changing regimes – as an entertainment or as a propaganda
Film Culture in Lithuania, 1926-1944: Between Entertainment and Ideology.
No full textIn 1926-1944, three non-democratic (Lithuanian tautininkai, soviet and Nazi) regimes with different ideologies changed in Lithuania. In this dissertation, author researched and compared such attributes of film culture in Lithuania as: the network of cinemas and its development; repertoire of screened films; film journalism in the country and film reflections in the literary imagination; and film reception. By doing so, the author tried to answer the question: how did the cinema functioned in the country during these changing regimes – as an entertainment or as a propaganda
Investigation of sewage sludge pyrolysis products and residual solid material influence to fibre hemp biomass production.
No full textThe quantities of sewage sludge generated in the treatment plants already pose serious problems related to its storage and use. The Article 14 of the Urban Waste Water Treatment Directive 91/271/EEC specifies, “Sewage sludge from waste water treatment shall be re-used whenever appropriate. Disposal routes shall minimize the adverse effects on the environment “. Therefore, priority is given to the reuse of sewage sludge, rather than disposal it to landfills or storage plants. The analysis of scientific literature related to the quantities of sewage sludge and its chemical composition, possibilities of its use in thermal process and possibilities of residual product use in other areas as a raw material was carried out by the author of dissertation. Sewage sludge samples were collected from the major water treatment systems in Lithuania during the preparation of dissertation. After investigation of their chemical quality, author selected sewage sludge samples from a small city (Šilutė) for a more detailed research. Author designed and constructed a pyrolysis stand where he carried out thermal decomposition (pyrolysis) of sewage sludge. Solid fraction as char obtained from sewage sludge was used in experimental research on cultivation of fibre hemp (Canabis sativa L.). In order to assess the regularities of distribution of heavy metals, alkaline earth metals and alkaline metals as well as of non-metals the author carried out chemical analysis of sewage sludge, sludge pyrolysis products and gifferent parts of fibre hemp (roots, stem, leaves). According to the results author found distribution of elemental migration in the course of the application of the principle of sustainable use of sewage sludge
Nuotekų dumblo pirolizės proceso produktų ir susidariusios kietosios frakcijos įtakos pluoštinės kanapės biomasės prieaugiui tyrimas.
No full textThe quantities of sewage sludge generated in the treatment plants already pose serious problems related to its storage and use. The Article 14 of the Urban Waste Water Treatment Directive 91/271/EEC specifies, “Sewage sludge from waste water treatment shall be re-used whenever appropriate. Disposal routes shall minimize the adverse effects on the environment “. Therefore, priority is given to the reuse of sewage sludge, rather than disposal it to landfills or storage plants. The analysis of scientific literature related to the quantities of sewage sludge and its chemical composition, possibilities of its use in thermal process and possibilities of residual product use in other areas as a raw material was carried out by the author of dissertation. Sewage sludge samples were collected from the major water treatment systems in Lithuania during the preparation of dissertation. After investigation of their chemical quality, author selected sewage sludge samples from a small city (Šilutė) for a more detailed research. Author designed and constructed a pyrolysis stand where he carried out thermal decomposition (pyrolysis) of sewage sludge. Solid fraction as char obtained from sewage sludge was used in experimental research on cultivation of fibre hemp (Canabis sativa L.). In order to assess the regularities of distribution of heavy metals, alkaline earth metals and alkaline metals as well as of non-metals the author carried out chemical analysis of sewage sludge, sludge pyrolysis products and gifferent parts of fibre hemp (roots, stem, leaves). According to the results author found distribution of elemental migration in the course of the application of the principle of sustainable use of sewage sludge
Attitude of patients with oncological disease of the digestive system towards physiotherapy in the early postoperative period.
No full textABSTRACT Vilnius University Faculty of Medicine Health Science Institute Department of Rehabilitation, Physical and Sports Medicine Bachelor’s Degree of Physiotherapy ATTITUDE OF PATIENTS WITH ONCOLOGICAL DISEASE OF THE DIGESTIVE SYSTEM TOWARDS PHYSIOTHERAPY IN THE EARLY POSTOPERATIVE PERIOD Physiotherapy Bachelor’s Thesis The author: Nerijus Rutkauskas, a final year student in Bachelor’s of Physiotherapy of Vilnius University, Faculty of Medicine. Academic supervisor: lector Jūratė Kesienė, Vilnius University, Faculty of Medicine, Institute of Health Sciences, The Department of Rehabilitation, Physical and Sports Medicine. Keywords: attitude towards physiotherapy, abdominal surgery, early post-operative period, gastrointestinal oncological diseases, early mobilization. The aim of research work: To assess the attitude of patients suffering from oncological disease of the digestive system towards physiotherapy in the early postoperative period. Tasks of work: 1. To ascertain whether patients feel the benefits of physical therapy in the early postoperative period. 2. To identify the main barriers to patient mobilization in the early postoperative period. Materials and methods. The survey was conducted in the 1st and 2nd Abdominal Surgery Departments of Vilnius University Hospital Santaros Klinikos from February to March 2023. A total of 41 respondents, selected by convenience sampling, participated in the survey after gastrointestinal oncological surgery. A 25-question questionnaire using the Patient Mobility Survey was developed to determine the patients’ attitudes towards physiotherapy in the early postoperative period. The questions were divided into 4 groups: group I – questions 1,2,10,11,12,13,14,19,20 to obtain data on patients’ attitudes towards postoperative mobilization; group II – questions 3-6 to assess patients’ knowledge of mobilization; group III – questions 7,8,9,15,16 to investigate the role of the family members in mobilization; and group IV – questions 17-18 to analyse the mobilization care received in the hospital. The survey also contained questions 21-25 to assess the type of mobilization received, the time after surgery when mobilization was started, the reasons for anxiety during physiotherapy, and the opinion on the need for further mobilization. Data analysis was conducted using Microsoft Excel 2016 statistical analysis software. Data means, standard deviations were calculated. Results. A total of 41 patients diagnosed with various gastrointestinal oncological diseases undergoing abdominal surgery participated in the study. Low involvement of family members was found to be the biggest barrier to mobilization, with a score of 47,3±45,1. Lower barriers to mobilization were insufficient knowledge of mobilization (24,4±32,2 points) and negative attitudes towards mobilization (16,8±28 points). A majority of patients (n=38; 92,7%) agreed that early postoperative mobilization contributed to their recovery. 37 respondents (90,2%) strongly agreed or agreed that postoperative mobilization was necessary. Conclusions: 1. The results of the study show that a significant number of patients undergoing gastrointestinal oncology surgery experience benefits from physiotherapy in the early postoperative period. 2. The main barriers to mobilization in the early postoperative period were found to be low involvement of family members in mobilizing patients, insufficient patient knowledge and negative attitudes towards mobilization and its benefits
