Return to work after general surgery: A comparative study.

PURPOSES: There is scarce information on the time to return to work after general surgery. The aim of this study was to analyze time off work after elective cholecystectomy and to compare the results with those in patients undergoing other surgical interventions. METHODS: Observational and comparative study. Inclusion criteria were: being of working age and undergoing elective laparoscopic cholecystectomy (group 1) or unilateral inguinal hernia or haemorrhoidectomy (group 2). RESULTS: 36 patients were included: 18 patients in each group. Overall, return to work occurred at a mean of 35.7 days, with no significant differences (p=0.656) between groups (group 1: 36.6 days vs. group 2: 35.44 days). The reasons for not returning to work earlier were fear of complications (37.5%), pain control (37.5%), surgeon recommendation (12.5%), and general practitioner recommendation (12.5%). CONCLUSIONS: Time to recovery after laparoscopic cholecystectomy is prolonged. No statistically significant differences with less complex surgical procedures were detected.

Lista de espera en Cirugía General y Digestiva: expectativas del paciente, calidad de vida durante la espera y grado de satisfacción / Waiting list in general and digestive surgery: Patient expectations, quality of life during waiting time and overall satisfaction

Introducción. Los recursos estructurales del Sistema Nacional de Salud son limitados y no podemos intervenir quirúrgicamente a todos los pacientes precozmente. El objetivo fue analizar la satisfacción percibida por el paciente respecto a la demora de tratamiento por la lista de espera quirúrgica en 3 tipos de cirugía. También se analizó la influencia de la expectativa del paciente y de la alteración de la calidad de vida por síntomas durante la demora sobre la satisfacción del mismo con la espera. Material y métodos. Estudio prospectivo mediante una encuesta a pacientes intervenidos quirúrgicamente. Se compararon las expectativas de espera (escala del 1 al 5), la afectación de la calidad de vida por síntomas (escala del 1 al 5) y el grado de satisfacción de los pacientes (escala del 1 al 5) respecto al tiempo en lista de espera de colelitiasis, hernia inguinal y hemorroides. Se analizaron los factores predictores de insatisfacción de los pacientes. Resultados. Se incluyó una muestra 57 pacientes. Cuando se compararon las características de los pacientes con y sin satisfacción respecto al tiempo en lista de espera, el tiempo en la lista en días (p = 0,044), la alteración en la calidad de vida por síntomas (p = 0,028) y las expectativas de un tiempo inferior (p < 0,001) fueron significativamente diferentes entre ambos grupos. En el estudio multivariado la expectativa se asoció a la insatisfacción de los pacientes respecto al tiempo esperado (OR: 3,14, IC 95%: 5,91-220,73, p < 0,001). Conclusiones. El grado de insatisfacción de los pacientes está asociado, sobre todo, a las expectativas más que al propio tiempo de demora (AU)

Introduction: The structural resources of the National Health system are limited, and therefore early surgery cannot be performed on all patients. The objective was to analyse the satisfaction perceived by the patient as regards the delay of treatment by waiting list of three types of surgery. The influence of expectations on waiting times, and impaired quality of life due to the clinical symptoms during the delay, were studied. Material and methods: A prospective study was conducted using a postal questionnaire. We compared the expectations (scale of 1 to 5), the impact on quality of life for symptoms (scale of 1 to 5) and the level of patient satisfaction (scale of 1 to 5) with respect to time on the waitng list for cholelithiasis, inguinal hernia and haemorrhoids. The predictors of patient dissatisfaction were analysed. Results: A total of 57 patients were included. When comparing the characteristics of patients with and without satisfaction over time on the waiting list, days on the waiting list (P = .044), the change in the quality of life due to the symptoms (P = .028), and expectations (P <. 001) were significantly different between the two groups. In the multivariate analysis, the expectation was associated with patient dissatisfaction as regards the time on waiting list (OR: 3.14 95% CI: 5.91 to 220.73, P < .001). Conclusions: The level of patient dissatisfaction is associated with expectations about time in waiting list (AU)

[Waiting list in general and digestive surgery: patient expectations, quality of life during waiting time and overall satisfaction]. / Lista de espera en Cirugía General y Digestiva: expectativas del paciente, calidad de vida durante la espera y grado de satisfacción.

INTRODUCTION: The structural resources of the National Health system are limited, and therefore early surgery cannot be performed on all patients. The objective was to analyse the satisfaction perceived by the patient as regards the delay of treatment by waiting list of three types of surgery. The influence of expectations on waiting times, and impaired quality of life due to the clinical symptoms during the delay, were studied. MATERIAL AND METHODS: A prospective study was conducted using a postal questionnaire. We compared the expectations (scale of 1 to 5), the impact on quality of life for symptoms (scale of 1 to 5) and the level of patient satisfaction (scale of 1 to 5) with respect to time on the waitng list for cholelithiasis, inguinal hernia and haemorrhoids. The predictors of patient dissatisfaction were analysed. RESULTS: A total of 57 patients were included. When comparing the characteristics of patients with and without satisfaction over time on the waiting list, days on the waiting list (P=.044), the change in the quality of life due to the symptoms (P=.028), and expectations (P<.001) were significantly different between the two groups. In the multivariate analysis, the expectation was associated with patient dissatisfaction as regards the time on waiting list (OR: 3.14 95% CI: 5.91 to 220.73, P<.001). CONCLUSIONS: The level of patient dissatisfaction is associated with expectations about time in waiting list.

Evidencia de translocación bacteriana en un modelo experimental de politraumatismo / Fevidence of bacterial translocation in an experimental model of multiple trauma

Objetivo. Analizar la relación entre el politraumatismo y la translocación bacteriana en un modelo experimental. Material y métodos. Se ha utilizado 132 ratones Balb/c de 8 a 12 semanas de vida, siendo traumatizados mediante el Aparato Generador de Politraumatismo, con una mortalidad prevista del 20 por ciento. Se ha determinado la translocación bacteriana a las 0, 4, 8, 12, 24, 48 y 72 h tras la agresión. Se ha analizado mediante test exacto de Fisher. Resultados. La translocación global en el grupo control fue del 14,3 por ciento; la translocación en el grupo politraumatizado fue del 70 por ciento (p < 0,00001). Con un intervalo de confianza del 95 por ciento, el número de colonias por gramo de ganglio linfático fue de 1 a 3.6 en el grupo control y entre 20,7 y 127,7 en el grupo traumatizado. Las diferencias entre el grupo control y el traumatizado a los intervalos de tiempo descritos son significativas a las 8 h (p = 0,01), 12 h (p = 0,041), 24 h (p = 0,041) y a las 72 h (p = 0,041), según test exacto de Fisher. Conclusión. Existe una translocación bacteriana precoz tras un politraumatismo experimental. Creemos que esta translocación puede actuar como un importante activador del fallo multiorgánico tras el politraumatismo (AU)