Biomedical subjects

Per Billesbølle

Publications and source records attributed to Per Billesbølle.

3 recordsLinked to original sources

PubMed2005

Functional recovery after open versus laparoscopic colonic resection: a randomized, blinded study.

BACKGROUND: Laparoscopic colonic surgery has been claimed to hasten recovery and reduce hospital stay compared with open operation. Recently, enforced multimodal rehabilitation (fast-track surgery) has improved recovery and reduced hospital stay in both laparoscopic and open colonic surgery. Since no comparative data between laparoscopic and open colonic resection with multimodal rehabilitation are available, the value of laparoscopy per se is unknown. METHODS: In a randomized, observer-and-patient, blinded trial, 60 patients (median age 75 years) underwent elective laparoscopic or open colonic resection with fast-track rehabilitation and planned discharge after 48 hours. Functional recovery was assessed in detail during the first postoperative month. RESULTS: Median postoperative hospital stay was 2 days in both groups, with early and similar recovery to normal activities as assessed by hours of mobilization per day, computerized monitoring of motor activity assessed, pulmonary function, cardiovascular response to treadmill exercise, pain, sleep quality, fatigue, and return to normal gastrointestinal function. There were no significant differences in postoperative morbidity, mortality, or readmissions, although 3 patients died in the open versus nil in the laparoscopic group. CONCLUSION: Functional recovery after colonic resection is rapid with a multimodal rehabilitation regimen and without differences between open and laparoscopic operation. Further large-scale studies are required on potential differences in serious morbidity and mortality.

Activities of Daily Living↗

PubMed2002

Early recovery after abdominal rectopexy with multimodal rehabilitation.

PURPOSE: Abdominal rectopexy without sigmoid resection is usually associated with a hospital stay of four to ten days. Recent developments have shown that a multimodal rehabilitation program with epidural analgesia and early oral feeding and mobilization will reduce hospital stay after colonic resection. The aim of this study was to describe the results after abdominal rectopexy with a multimodal rehabilitation program. METHODS: Thirty-one consecutive patients with rectal prolapse, median age 69 (range, 24-85) years and including 14 patients of American Society of Anesthesiologists physical status III to IV, were scheduled for abdominal rectopexy with a multimodal rehabilitation program including 48 hours thoracic epidural analgesia or patient-controlled anesthesia (3 patients), early oral nutrition and mobilization, and a planned two-day postoperative hospital stay. Follow-up was done at two months postoperatively. RESULTS: All patients except one tolerated normal diet and were mobilized to the same level as before surgery on the first postoperative day. Bowel movement was reestablished at a median of Day 2, and median postoperative hospital stay was three (mean, 4.4) days. At two months follow-up 16 percent were incontinent vs. 74 percent before surgery. Constipation was noted in 43 percent before surgery vs. 28 percent at two months follow-up. CONCLUSION: Median hospital stay after abdominal rectopexy may be reduced to three days with postoperative multimodal rehabilitation.

Abdominal Muscles↗

PubMed2002

Colostomy closure after Hartmann's procedure with fast-track rehabilitation.

PURPOSE: The aim of this study was to assess the effect of postoperative multimodal rehabilitation after colostomy closure after Hartmann's procedure. METHODS: Twenty-seven consecutive patients scheduled for colostomy closure after Hartmann's procedure received continuous postoperative epidural analgesia, laxative, and enforced oral liquids, protein drinks, and mobilization. RESULTS: Defecation occurred at a median 2 days postoperatively. Mean and median postoperative stay was 3 days, with two readmissions (1 anastomotic dehiscence and 1 social) increasing mean total 1-month hospital stay to 4.3 (median, 3) days. No other complications occurred except three superficial wound infections. CONCLUSION: Postoperative hospital stay and morbidity may be reduced with multimodal rehabilitation after open colostomy closure after Hartmann's resection.

Adult↗