Stress response in open and laparoscopic procedures

Raja Sekar, V P (2016) Stress response in open and laparoscopic procedures. Masters thesis, Kilpauk Medical College, Chennai.


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AIM OF STUDY: To determine the less stressful procedure among the open and laparoscopic procedures. MATERIALS AND METHODS: Study Group: Patient admitted in general surgical wards having sub acute appendicitis, inguinal hernia and symptomatic cholelithiasis. Study Design: Prospective Study Place of Study: Department of General Surgery, Govt Kilpauk Medical College and Hospital, Kilpauk, Chennai – 10 DURATION OF STUDY : 6 months Sample Size: 100 patients (50 Open surgeries and 50 laparoscopic surgeries) METHODOLOGY: Inclusion Criteria : • Patient in the age group of above 18 years and below 45 years. • Patient proven to have sub acute appendicitis, inguinal hernia and symptomatic cholelithiasis undergoing open and laparoscopic procedures with duration of surgery less than 2 hours. Exclusion Criteria: • Patient having diabetes, hypertension, asthma, tuberculosis, epilepsy, and psychiatric disorder. • Patient on any drugs for chronic illness. • Patient positive for HIV, HbsAg, and Anti HCV. Study Variables: • Serum cortisol, • Serum glucose, • Serum CRP. Data Collection: The blood samples are collected at the time of admission and 6 hrs after the surgery. The serum cortisol , glucose and CRP are analysed in the blood samples. The pre operative and post operative serum cortisol, glucose, and CRP are compared in open and laparoscopic group separately. RESULTS: The pre operative cortisol, glucose and CRP were compared between open and laparoscopic group, and it is found to be statistically insignificant (P value greater than 0.05) . The post operative cortisol, glucose and CRP was found to less in laparoscopic group compared to open surgical group. The difference was found to be statistically significant and P value is 0.0001. The laparoscopic surgery is the less stress full procedure when compared to the open surgical procedure. CONCLUSION: In our prospective study of 100 patients , by comparing the stress response in open surgical and laparoscopic group, the laparoscopic group shows the less stress response to surgery among two groups. The patients undergone laparoscopic surgery also shows the less change of surgical site wound infection and early fast recovery post operatively when compared to the open surgical group. By comparing the pre operative level of cortisol, CRP and glucose in open surgical and laparoscopic group there is not much difference between the two groups. The pre operative P value for the cortisol, glucose and CRP are not less than 0.05. It indicates there is no statistically significant difference between the two groups pre operatively. By comparing the post operative level of serum cortisol , CRP and glucose , the laparoscopic group has much less stress response compared to open surgical group with P value less than 0.05. From our study I conclude that the recently advanced laparoscopic surgical procedure was best procedure with less stress, less pain, less anxiety, early recovery from hospital stay and economic to the patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Stress response ; open and laparoscopic procedures.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 12 Oct 2017 00:50
Last Modified: 12 Oct 2017 00:52

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