Comparison of Postoperative Respiratory Function after Laparoscopy or Open Laparotomy for Cholecystectomy

Putensen-Himmer, Gabriele; Putensen, Christian; H, Lammer; Lingnau, Werner; Aigner, Franz; Benzer, H

doi:10.1097/00000542-199210000-00010

Cited by 153 publications

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“…And had a major role in young females when it is difficult to distinguish between acute appendicitis and gynecological clinical conditions like "Pelvic Inflammatory disease", "Twisted ovary" and ectopic pregnancy etc. [5][6][7] Laparoscopic procedures had rarer postoperative respiratory complications compared to open surgery. 8,9 Advantages of laparoscopic appendectomy are its better visualisation of organs, shorter hospital stay, fewer wound infection, less post-operative pain and rapid coming back to work.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus open appendectomy retrospective study

et al. 2017

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Background: Laparoscopic cholecystectomy is taken into account as a standard method of performing cholecystectomy and has substituted the old method throughout the world, while laparoscopic appendectomy still not attaining that reputation. In this paper, a retrospective study was done to compare between both laparoscopic and open appendectomy.Methods: Two hundred eighty-five patients were analyzed after appendectomy using either open or laparoscopic procedures. The data was compared over a period of 36 months. Surgical technique was the same among 6 surgeons, standard postoperative care for all patient groups. The outcome measures included comparing of mean operative time, days of hospitalization, postoperative pain and rate of wound infection.Results: Concerning open appendectomy the mean time was 28 minutes with 2 days of hospitalization. The postoperative pain extent was for 36 hours and rate of wound infection was 8/159. While in laparoscopic appendectomy the mean time was 55 minutes with one day hospitalization. The postoperative pain was for 12 hours and zero rate of wound infection.Conclusions: In general laparoscopy has plenty of gains over open surgery as discussed before but laparoscopic appendectomy is not easier, nor does it avoid general anesthesia. The cost for laparoscopic appendectomy is higher than for open appendectomy. The operative and post-operative complications are more critical (e.g.: intra-abdominal abscesses & perforation of bowel) as compared to open appendectomy. We have to assess the advantages and disadvantages, indications and contraindications when taking a decision for laparoscopic surgery. We suppose it would be very early to say that laparoscopic appendectomy is superior or can replace open appendectomy.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic versus open appendectomy retrospective study

et al. 2017

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“…However, no differences between the two groups were noted for PaCe2 and pH. 3 The escape of gas into the thoracic cavity through a congenital defect in the diaphragm (patent pleuroperitoneal canal) or from a tear in the diaphragm may result in pneumothorax, j.4 In our case, no defect could be demonstrated upon observation of the left diaphragm with the laparoscope. The pneumothorax was caused by a tear in the diaphragm during the fundoplication causing gas to enter the left pleural space.…”

Section: Discussionmentioning

confidence: 44%

Pneumothorax during laparoscopic Nissen fundoplication

et al. 1994

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We present a case of 100% pneumothorax in a 41-yr- The higher mortality and protracted hospital stay from laparotomy, and the recent improvement in instrumentation, have increased the popularity of laparoscopy, i Laparoscopy has been extended to include appendicectomy, inguinal hernia repair, laparoscopic nephrectomy, splenectomy, hemicolectomy, and in our case Nissen fundoplication. 2 The use of laparoscopy has eliminated the upper abdominal incision, and the impairment of pulmonary mechanics and ventilation. 3 Consequently, patients can be discharged from the hospital earlier. We report the complication of left pneumothorax which occurred during laparoscopy for Nissen fundoplication. The pneumothorax was caused probably by a rent in the diaphragm during the procedure permitting gas to enter the left chest. Case reportThe patient was a 41-yroold, 97-kg man undergoing laparoscopic Nissen fundoplication for gastritis, gastroesophageal reflux, and a hiatal hernia. His physical examination and laboratory values were within normal limits. Medications included ranifidine 150 mg po twice daily.Generalanaesthesia was induced with thiopentone 500 mg/v followed by succinylcholine 120 mg/v to facilitate tracheal intubation with an 8.0 millimeter cuffed tracheal tube. Anaesthesia was maintained with oxygen and nitrous oxide in a 1:3 ratio and 1.5% inspired isoflurane. The patient also received atracurium 50 mg/v for maintenance of neuromuscular blockade. Monitors included blood pressure, end-tidal carbon dioxide, ECG, oximetry, and nerve stimulator.Abdominal insufflation was performed with carbon dioxide and the trocars were placed uneventfully. The patient was placed in a 30 ~ reverse Trendelenburg position to assist with surgical exposure. The peak inspiratory CAN J ANAESTH 1994 / 41:9 / pp 854--6

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“…Postoperative pain intensity plays a major role in preserving pulmonary function after surgery [29] [30]. In the current trial, the VAS pain and nausea and vomiting scores did not differ significantly between the two MV strategies.…”

Section: Discussionmentioning

confidence: 50%

Pressure-Controlled Inverse Ratio Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function

Wang¹,

Wang²,

Wang³

et al. 2016

JBiSE

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Background: Studies have shown that pressure-controlled ventilation improves alveolar gas distribution. And inverse ratio ventilation has advantages of improving oxygenation in acute respiratory distress syndrome (ARDS) patients. However, the effects that pressure-controlled inverse ration ventilation in patients undergoes endotracheal intubation general anesthesia have not been assessed. Objective: To investigate whether pressure-controlled inverse ratio ventilation (PIV) would improve ventilatory and oxygenation parameters as well as lung function compared to conventional ventilation in patients undergoing open abdominal surgery. Interventions: In the conventional ventilation (CV) group, the ventilation strategy involved zero end-expiratory pressure and volume-controlled ventilation. In the pressure-controlled inverse ratio ventilation (PIV) group, the strategy involved P high starting at 7 cm H2O, P low starting at 4 cm H 2 O, T high at 4 s, T low at 2 s, and an inspiratory-to-expiratory time ratio of 2:1. The ΔP value was adjusted according to V T . Pressure levels were increased by 2 cm H 2 O until a maximal V T was observed. Inspired oxygen fraction (FIO 2 ) was 1.0 and tidal volume (V T ) was 6 mL/kg in both groups. Main Outcome Measures: The primary outcome is pulmonary function tests. Hemodynamic, ventilatory and oxygenation parameters were measured; visual analog scale (VAS) scores, and nausea and vomiting scores were also measured. Results: The PIV group tolerated pressure-controlled inverse ratio ventilation without significant hemodynamic instability. Mean airway pressure and static compliance were significantly higher in the PIV group than those in CV group (P < 0.05). Patients in the PIV group showed better pulmonary function test results on postoperative day 1 (P < 0.05). VAS and nausea and vomiting scores did not differ significantly between the two groups. Conclusion: Pressure-controlled inverse ratio ventilation during open abdominal surgery lasting >2 h was well tolerated and improved respiratory compliance and lung function on the first postoperative day.

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Comparison of Postoperative Respiratory Function after Laparoscopy or Open Laparotomy for Cholecystectomy

Cited by 153 publications

References 0 publications

Laparoscopic versus open appendectomy retrospective study

Laparoscopic versus open appendectomy retrospective study

Pneumothorax during laparoscopic Nissen fundoplication

Pressure-Controlled Inverse Ratio Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function

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