Le parcours de l’opéré en neuro-urologie : de la programmation opératoire à la convalescence. L’avis d’expert du Comité de neuro-urologie de l’AFU
Autor: | R. Caremel, M. Bertrandy-Loubat, Véronique Phé, M. de Sèze, M. Mazerolles, F. Duchene, M.-C. Scheiber-Nogueira, X. Gamé, S. Bart, Evelyne Castel-Lacanal, Gilles Karsenty |
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Rok vydání: | 2013 |
Předmět: |
medicine.medical_specialty
Rehabilitation medicine.diagnostic_test business.industry Urology medicine.medical_treatment Hyperreflexia medicine.disease Urologic Surgical Procedure Preoperative care Nursing care Quality of life (healthcare) Medicine medicine.symptom business Intensive care medicine Laparoscopy Spinal cord injury |
Zdroj: | Progrès en Urologie. 23:309-316 |
ISSN: | 1166-7087 |
DOI: | 10.1016/j.purol.2012.11.006 |
Popis: | The surgical care pathway of neurologic patients has two aims: preventing urinary morbidity and mortality and improving their quality of life. It requires taking into account the specificities of disabilities in domains of body functions: circulatory, ventilation and digestive physiology, motor functions, sensory functions, mental functions, and skin fragility which are responsible of dependencies in this heterogeneous group of patients. This management is necessarily multidisciplinary to be optimal and through specific clinical care pathway, providing guidance to the surgical procedure: preparation of the surgery, its realization, and post-operative rehabilitation. The indication for surgery must be coordinated and validated in neuro-urology multidisciplinary staff. Preoperative stay in a physical and rehabilitation medicine center may be useful to ensure a complete assessment and anticipate problems related to surgery. The patient will be hospitalized in the urology department in a single room suited to their disabilities and handicaps. The chronic treatments should be not modified if possible. The lack of sensitivity does not dispense anesthesia to prevent autonomic hyperreflexia, the most severe complication after high complete spinal cord injury. The laparoscopy and sub-peritoneal surgery, the early removal nasogastric tube and early refeeding make it possible to early resumption of intestinal transit. In many cases, the patients should be transferred to a physical and rehabilitation medicine during post-operative period where the nursing care will be most suitable. A quickly adapted rehabilitation must be able to reduce loss of function and physical dependence. |
Databáze: | OpenAIRE |
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