RESUMO
Prehabilitation is a set of interventions aimed at increasing the patient's endurance and functional capacity before a planned stressful event (oncogynaecological surgery). Currently, prehabilitation is based on three main modalities which are: physiotherapy, nutritional support and psychological support, with others gradually being added. In studies published to date, a positive effect of combined preoperative intervention on the patient's postoperative recovery reduces the risk of perioperative and postoperative complications, shortening the hospital stay. This directly reduces the costs associated with cancer treatment.
Assuntos
Exercício Pré-Operatório , Humanos , Exercício Pré-Operatório/fisiologia , Neoplasias/cirurgia , Neoplasias/reabilitação , Cuidados Pré-Operatórios/métodos , Modalidades de Fisioterapia , Apoio Nutricional/métodos , Feminino , Procedimentos Cirúrgicos em Ginecologia/métodos , Procedimentos Cirúrgicos em Ginecologia/reabilitaçãoRESUMO
AIM: Aim of the study to summarize the current information on diagnostic and treatment options for uterovesical fistula as a consequence of iatrogenic complication. Methods: Literature review of available information on surgical treatment options for uterovesical fistula resulting from previous caesarean section and comparison with our own experience in the developing world. Conclusion: Uterovesical fistula is an abnormal communication between the bladder and uterus. The cause of this pathology in most cases is an iatrogenic complication, most commonly arising after a caesarean section. The incidence of this pathology varies significantly geographically. In developed countries, these fistulas are rather rare. On the other hand, in developing countries, uterovesical fistulas are more common with a significant impact on the subsequent life of the patient due to generally inaccessible health care.
Assuntos
Fístula , Fístula da Bexiga Urinária , Doenças Uterinas , Gravidez , Humanos , Feminino , Cesárea/efeitos adversos , Fístula da Bexiga Urinária/diagnóstico , Fístula da Bexiga Urinária/etiologia , Fístula da Bexiga Urinária/cirurgia , Fístula/diagnóstico , Fístula/etiologia , Fístula/cirurgia , Doenças Uterinas/diagnóstico , Doenças Uterinas/cirurgia , África Subsaariana/epidemiologia , Doença IatrogênicaRESUMO
OBJECTIVE: To describe the implementation process and evaluate the success of compliance with the recommended ERAS protocol in the Czech healthcare system. METHODS: The study included 163 patients from March to September 2022, a total of 7 months. Patients were divided into three groups according to the type of surgery. Clinical protocol: Oncogynecology, hysterectomy and laparoscopy. The implementation was realized in three phases (preparation, implementation of the protocol itself and evaluation). RESULTS AND CONCLUSIONS: The cumulative adherence rate was 90% or more in all three groups. Based on the pilot results at our department, we evaluated the ERAS concept as a well-implemented tool for gynaecological departments in the Czech healthcare system.
