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Patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy

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  • Veronica Ramirez Johansson
  • Ann‐Christin von Vogelsang

Abstract

Aims and objectives To describe patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy in patients with bladder cancer. Background Preventive activities for remaining patient safety due to correct positioning play an important part in perioperative nursing care.Extremity injuries are well‐known after prolonged surgery, especially in robot‐assisted urologic surgery in the steep Trendelenburg position. The risk of injury increases due to patient‐related and operative risk factors. Methods A quantitative prospective observational study was conducted. Patients were followed up with the QuickDASH (Disabilities in the Arm, Shoulder and Hand), Lower Extremity Functional Scale (LEFS) and a study‐specific questionnaire 7–10 days and monthly, up to six months after surgery in patients with extremity symptoms. The study adheres to STROBE (strengthening the reporting of observational studies in epidemiology) guidelines, see Supporting information File S1. Results Out of the 94 included participants, 46.8% (n = 44) experienced extremity symptoms 7–10 days after surgery. Pain, numbness and weakness were the most frequent symptoms. There was a discrepancy between the patients reported symptoms and the documentation in the patient records. Only 13.6% (n = 3) of the reported pain was documented, respectively 27.5% (n = 11) of other symptoms. Conclusion A large proportion of the patients report postoperative extremity symptoms after robot‐assisted laparoscopic cystectomy. Prevention of complications in the perioperative setting, are together with follow‐ups, important nursing activities for maintaining patient safety and may both prevent and detect postoperative extremity symptoms and injuries. Relevance to clinical practice This study reveals the need of accurate documentation regarding extremity symptoms in digital patient records, as well as continuous follow‐ups during the hospital stay and after hospital discharge to enable detection of treatable extremity injuries. The result of this study also indicates the importance of nursing activities such as evidence‐based positioning guidelines in the operating theatre for optimal positioning.

Suggested Citation

  • Veronica Ramirez Johansson & Ann‐Christin von Vogelsang, 2019. "Patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(9-10), pages 1708-1718, May.
    • Handle: RePEc:wly:jocnur:v:28:y:2019:i:9-10:p:1708-1718
    DOI: 10.1111/jocn.14781
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    References listed on IDEAS

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    1. Erebouni Arakelian & Christine Leo Swenne & Susan Lindberg & Gudrun Rudolfsson & Ann‐Christin von Vogelsang, 2017. "The meaning of person‐centred care in the perioperative nursing context from the patient's perspective – an integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(17-18), pages 2527-2544, September.
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