Effects of laparotomy or laparoscopicprocedures for cholecystectomy on diaphragmatic and thoracoabdominal mobility

Abstract

Design of the study: Observational descriptive and cross sectional study. Objective: To verify the effects of laparotomy or laparoscopicprocedures for cholecystectomy on lung function, diaphragmatic and thoracoabdominal mobility. Methods: We evaluated 18 individuals who underwent cholecystectomy by either laparotomy (CLG n=9) or by a laparoscopic procedure (LCG, n=9). The participants were evaluated in preoperative and in the 2nd postoperative day: anthropometrics measures, cardiorrespiratory parameters, intensity of pain, pulmonary function, diaphragmatic mobility and thoracoabdominal mobility. For statistical analysis, the Wilcoxon test was applied to compare the pre and postoperative of both groups, Mann-Whitney test was applied to comparison between groups (p≤0.05). Results: Diaphragmatic mobility was reduced in both groups whereas thoracoabdominal mobitity al all levels were reduced only in CLG (p<0.05). In LCG, there was a significant decrease of thoracoabdominal mobility only in the umbilical region (p<0.008). By comparing the values of thoracoabdominal mobility between groups postoperatively, there was a difference only in umbilical mobility (p=0.02). We found a significant reduction in vital capacity (VC) in LCG only (p=0.05). Conclusion: Laparotomy and laparoscopic procedures for cholecystectomy reduce the mobility of the diaphragm, but only laparotomy impairs thoracoabdominal mobility in the three levels, axillary, xiphoid and umbilical