PDF(Pubmed)
Abstract：
BACKGROUND: Hernia repairs account for millions of general surgical procedures performed each year worldwide, with a notable shift to outpatient settings over the last decades. As technical possibilities such as smartphones, tablets, and different kinds of probes are becoming more and more available, such systems have been evaluated for applications in various clinical settings. However, there have been few studies conducted in the surgical field, especially in general surgery.
OBJECTIVE: We aimed to assess the feasibility of a tablet-based follow up to monitor activity levels after repair of abdominal wall hernias and to evaluate a possible reduction of adverse events by their earlier recognition.
METHODS: Patients scheduled for elective surgical repair of minor abdominal wall hernias (eg, inguinal, umbilical, or trocar hernias) were equipped with a telemonitoring system, including a tablet, pulse oximeter, and actimeter, for a monitoring phase of 7 days before and 30 days after surgery. Descriptive statistical analyses were performed.
RESULTS: We enrolled 16 patients with a mean overall age of 48.75 (SD 16.27) years. Preoperative activity levels were reached on postoperative day 12 with a median of 2242 (IQR 0-4578) steps after plunging on the day of surgery. The median proportion of available activity measurements over the entire study period of 38 days was 69% (IQR 56%-81%). We observed a gradual decrease in the proportion of available data for all parameters during the postoperative course. Six out of ten patients (60%) regained preoperative activity levels within 3 weeks after surgery. Overall, patients rated the usability of the system as relatively easy.
CONCLUSIONS: Tablet-based follow up is feasible after surgical repair of minor abdominal wall hernias, with good adherence rates during the first couple of weeks after surgery. Thus, such a system could be a useful tool to supplement or even replace traditional outpatient follow up in selected general surgical patients.
OBJECTIVE: We aimed to assess the feasibility of a tablet-based follow up to monitor activity levels after repair of abdominal wall hernias and to evaluate a possible reduction of adverse events by their earlier recognition.
METHODS: Patients scheduled for elective surgical repair of minor abdominal wall hernias (eg, inguinal, umbilical, or trocar hernias) were equipped with a telemonitoring system, including a tablet, pulse oximeter, and actimeter, for a monitoring phase of 7 days before and 30 days after surgery. Descriptive statistical analyses were performed.
RESULTS: We enrolled 16 patients with a mean overall age of 48.75 (SD 16.27) years. Preoperative activity levels were reached on postoperative day 12 with a median of 2242 (IQR 0-4578) steps after plunging on the day of surgery. The median proportion of available activity measurements over the entire study period of 38 days was 69% (IQR 56%-81%). We observed a gradual decrease in the proportion of available data for all parameters during the postoperative course. Six out of ten patients (60%) regained preoperative activity levels within 3 weeks after surgery. Overall, patients rated the usability of the system as relatively easy.
CONCLUSIONS: Tablet-based follow up is feasible after surgical repair of minor abdominal wall hernias, with good adherence rates during the first couple of weeks after surgery. Thus, such a system could be a useful tool to supplement or even replace traditional outpatient follow up in selected general surgical patients.
摘要：
背景：疝修补术占全世界每年进行的数百万次普通外科手术，在过去的几十年里，门诊设置显著转变。作为智能手机等技术可能性，片剂,不同种类的探针变得越来越可用，这种系统已经在各种临床环境中的应用进行了评估。然而,在外科领域进行的研究很少，尤其是在普外科。
目的：我们旨在评估基于片剂的随访监测腹壁疝修复后活动水平的可行性，并通过早期识别来评估可能减少不良事件的可能性。
方法：计划择期手术修复小腹壁疝的患者（例如，腹股沟,脐带缆,脐带缆或套管疝)配备了远程监测系统，包括平板电脑,脉搏血氧计,和电位计,用于手术前7天和手术后30天的监测阶段。进行描述性统计分析。
结果：我们招募了16名患者，平均总年龄为48.75（SD16.27）岁。术后第12天达到术前活动水平，手术当天骤降后中位数为2242（IQR0-4578）步。在整个38天的研究期间,可用活性测量的中值比例为69%(IQR56%-81%)。我们观察到术后过程中所有参数的可用数据比例逐渐降低。十分之六的患者（60％）在术后3周内恢复了术前活动水平。总的来说,患者认为系统的可用性相对容易。
结论：小腹壁疝手术修复后，基于片剂的随访是可行的，在手术后的前几周内具有良好的依从率。因此，这样的系统可能是一个有用的工具，以补充甚至取代传统的门诊随访在选定的普外科患者。
目的：我们旨在评估基于片剂的随访监测腹壁疝修复后活动水平的可行性，并通过早期识别来评估可能减少不良事件的可能性。
方法：计划择期手术修复小腹壁疝的患者（例如，腹股沟,脐带缆,脐带缆或套管疝)配备了远程监测系统，包括平板电脑,脉搏血氧计,和电位计,用于手术前7天和手术后30天的监测阶段。进行描述性统计分析。
结果：我们招募了16名患者，平均总年龄为48.75（SD16.27）岁。术后第12天达到术前活动水平，手术当天骤降后中位数为2242（IQR0-4578）步。在整个38天的研究期间,可用活性测量的中值比例为69%(IQR56%-81%)。我们观察到术后过程中所有参数的可用数据比例逐渐降低。十分之六的患者（60％）在术后3周内恢复了术前活动水平。总的来说,患者认为系统的可用性相对容易。
结论：小腹壁疝手术修复后，基于片剂的随访是可行的，在手术后的前几周内具有良好的依从率。因此，这样的系统可能是一个有用的工具，以补充甚至取代传统的门诊随访在选定的普外科患者。
