The Concept of "Fast Track Surgery" as an Influencer on the Dynamics of Components of Stress-Realizing and Stress-Limiting Systems in the Perioperative Period

Authors

  • Oksana Yu. Gerbali 1st Faculty of Medicine, Department of Surgery No. 1, Medical Academy named after S.I. Georgievsky, Vernadsky Crimea Federal University, 294006, Lenin Ave. 5/7, Simferopol, Russian Federation
  • Lesya N. Gumenyuk Faculty of Training of Medical Personnel of the Highest Qualification and Additional Vocational Education, Department of Psychiatry, Narcology, Psychotherapy with the Course of General and Medical Psychology, Medical Academy named after S.I. Georgievsky, Vernadsky Crimea Federal University, 294006, Lenin Ave. 5/7, Simferopol, Russian Federation
  • Elena V. Sarchuk 2nd Faculty of Medicine, Department of General and Ecological Hygiene, Medical Academy named after S.I. Georgievsky, Vernadsky Crimea Federal University, 294006, Lenin Ave. 5/7, Simferopol, Russian Federation
  • Enver Ya. Kerimov 1st Faculty of Medicine, Department of Surgery No. 1, Medical Academy named after S.I. Georgievsky, Vernadsky Crimea Federal University, 294006, Lenin Ave. 5/7, Simferopol, Russian Federation
  • Nariman E. Karakursakov International Faculty, Department of General Surgery, Medical Academy named after S.I. Georgievsky, Vernadsky Crimea Federal University, 294006, Lenin Ave. 5/7, Simferopol, Russian Federation

DOI:

https://doi.org/10.6000/2292-2598.2019.07.04.3

Keywords:

Fast Track Surgery, simultaneous operations, combined pathology, stress-realizing and stress-limiting system.

Abstract

The concept of "Fast Track Surgery" has been of increasing interest, which implies accelerated recovery and a decrease in the frequency of postoperative complications, namely, a decrease in the body's stress response to surgery. The study aimed to assess the effect of Fast Track Surgery on the degree of surgical treatment trauma based on the dynamics of the functional integration of hormonal components of the stress-realizing / stress-limiting systems in the perioperative period. The study was conducted in 3 groups of patients. Groups of patients are comparable in age, sex, diagnosis of an underlying disease, degree of operative-anaesthetic risk ASA, intraoperative parameters, which allowed to carry out an analytical evaluation of the results of the study as objectively and reliably as possible. In the postoperative period, the maximum increase in stress-realizing system parameters in all groups was registered in patients after 1 day after surgery, less significant after LSSI-F: the concentration of daily excretion of dopamine exceeded the preoperative values by 1.2 times, epinephrine 2.0 times, norepinephrine in 1.3 times. Along with the activation of the stress-realizing system, a dynamic increase in the activity of the stress-limiting system was noted: after LSSI-F, the level of GABA increased by 1.3 times, after TSSI, the GABA secretion increased 1.2-fold. Laparoscopic SSI in combination with "Fast Track Surgery" contributed to a decrease in the intensity of the patient's stress response to the operating injury, which, in turn, significantly increased the effectiveness of simultaneous treatment and the quality of life of patients.

References

Vertkin AL, Rumyantsev MA, Skotnikov AS. Comorbidity. Clin Med 2012; 10: 4-11.

World Health Organization. 2015. World Report on Ageing and Health. Geneva [Electronic resource]. – World Health Organization. [updated 2015 Oct 30; cited 2018 Sept 20]: Available from: http://www.who.int/ageing/events/world-report-2015-launch/en

Vertkin AL, Sotnikov AS. Comorbidity. Kazan Med Zh 2014; 95(2): 292-296. DOI: https://doi.org/10.17816/KMJ2084

Kehlet H. The surgical stress response: should it be prevented? Can J Surg 1991; 34(6): 565-567.

Kehlet H. Fast-track surgery – an update on physiological are principles to enhance recovery. Langenbecks Arch Surg 2011; 396(5): 585-590. https://doi.org/10.1007/s00423-011-0790-y DOI: https://doi.org/10.1007/s00423-011-0790-y

Antipin EE, Uvarov DN, Antipina NP, Nedashkovsky EV, Sovershaeva SL. Early multimodal rehabilitation with abdominal hysterectomy – an impact on the postoperative period. Anesthesiol Reanimatol 2013; 6: 37-41.

Antipin EE, Uvarov DN, Svirsky DA, et al. Implementation of the principles of Fast Track in cesarean section. Anesthesiol Reanimatol 2011; 3: 33-36.

Pshennikova MG. The phenomenon of stress. Emotional stress and its role in pathology. Pathol Physiol & Exper Ther 2000; 2: 24-31.

Yumatov EA. Central peptidergic mechanisms of resistance to emotional stress. In: Sudakova KW, Petrova VI, editors. Emotional stress: theoretical and clinical aspects. Volgograd: Nauka, 1997; pp. 134-138.

Ashmarin IP, Karazeeva EP. Neuropeptides. In Ashmarin IP, Stukalov PV, editors. Neurochemistry. Moscow: Nauka, 1996; pp. 296-333.

Lassen K, Hannemann P, Ljungqvist O, et al. Patterns in current perioperative practice: survey of colorectal sur-geons in five northern European countries. BMJ 2005; 330: 1420-142187. https://doi.org/10.1136/bmj.38478.568067.AE DOI: https://doi.org/10.1136/bmj.38478.568067.AE

Hannemann P, Lassen K, Hausel J, et al. Patterns in current anaesthesiological peri-operative practice for colonic resections: asurvey in five Northern-European countries. Acta Anaesthesiol Scand 2006; 50: 1152-116088. https://doi.org/10.1111/j.1399-6576.2006.01121.x DOI: https://doi.org/10.1111/j.1399-6576.2006.01121.x

Kehlet H, Buchler MW, Beart RW Jr, et al. Care after colonic operation – is it evidence-based? Results from a multinational survey in Europe and the United States. J Am Coll Surg 2006; 202: 45-5489. https://doi.org/10.1016/j.jamcollsurg.2005.08.006 DOI: https://doi.org/10.1016/j.jamcollsurg.2005.08.006

Vinogradov AE, Shilina MA, Anatskaya OV, et al. Molecular genetic analysis of human endometrial mesenchymal stem cells that survived sublethal heat shock. Stem Cells International 2017; 2017: 2362630. https://doi.org/10.1155/2017/2362630 DOI: https://doi.org/10.1155/2017/2362630

Baimbetov A, Kuzhukeyev M, Bizhanov K, et al. Atrial fibrillation ablation using second-generation cryoballoon. Cryoballoon ablation. New Armen Med J 2018; 12(1): 64-71.

Tishchenko AL, Gorskii VS, Sergeeva NS. Linear skin atrophy: Current information and modern approaches to the external therapy. Medic News North Cauc 2018; 13(3): 566-571. https://doi.org/10.14300/mnnc.2018.13106 DOI: https://doi.org/10.14300/mnnc.2018.13106

Zykova SS, Shurov SN, Talismanov VS, et al. Antiradical activity in the series of novel 4-(2,2-dimethylpropanoyl)-3-hydroxy-1,5-diaryl-1,5-dihydro-2H-pyrrol-2-ones: Experimental study and quantum chemical prediction. J Pharmac Sci & Res 2018; 10(4): 947-949.

Talismanov VS, Popkov SV, Karmanova OG, et al. Convenient way to experimentally determine the lipophilicity (logP) of new synthetic biologically active compounds using high-performance liquid chromatography in the series of 2,2- disubstituted 4-(1,2,4-triazol-1-ylmethyl)-1,3-dioxolanes. J Pharmac Sci & Res 2017; 9(12): 2372-2375.

Turganbekova AA, Ramilyeva RI, Baimukasheva DK, et al. Characterization of the novel HLA-A*32:95 allele, identified in the Republic of Kazakhstan. HLA 2017; 90(2): 112-113. https://doi.org/10.1111/tan.13028 DOI: https://doi.org/10.1111/tan.13028

Downloads

Published

2019-11-18

How to Cite

Gerbali, O. Y., Gumenyuk, L. N., Sarchuk, E. V., Kerimov, E. Y., & Karakursakov, N. E. (2019). The Concept of "Fast Track Surgery" as an Influencer on the Dynamics of Components of Stress-Realizing and Stress-Limiting Systems in the Perioperative Period. Journal of Intellectual Disability - Diagnosis and Treatment, 7(4), 220–226. https://doi.org/10.6000/2292-2598.2019.07.04.3

Issue

Section

General Articles