Cardiovascular and respiratory changes and convalescence in laparoscopic colonic surgery: comparison between carbon dioxide pneumoperitoneum and gasless laparoscopy.
Arch Surg
; 134(10): 1112-8, 1999 Oct.
Article
em En
| MEDLINE
| ID: mdl-10522857
ABSTRACT
HYPOTHESIS:
Gasless laparoscopy produces smaller cardiopulmonary and systemic changes than carbon dioxide (CO2) laparoscopy during colonic surgery.DESIGN:
Prospective randomized trial.SETTING:
Department of Surgery in a university hospital. PATIENTS Twenty-two patients scheduled for laparoscopic colonic resection; 5 patients were excluded because of conversion to open surgery (N = 17).INTERVENTIONS:
Patients were randomized to either gasless (n = 9) or conventional CO2 (n = 8) surgery. MAIN OUTCOMEMEASURES:
Intraoperative assessment of hemodynamic factors and pulmonary function, and postoperative assessment of pain, pulmonary function, convalescence, and various injury factors were done several times until 30 days after surgery. Surgical complications were noted.RESULTS:
Descending aorta blood flow after 30 minutes (P=.03) and heart rate after 150 minutes were higher in the CO2 group (P=.009). Central venous pressure, PaCO2 inspiration pressure, and end tidal CO2 level were significantly higher in the CO2 group (P = .05, .03, .04, and .01, respectively). Patients in the CO2 group had less pain during mobilization and coughing (P = .008 and .006, respectively), and were significantly more fatigued (P = .04). No other important differences were observed in intraoperative hemodynamic factors, postoperative convalescence, immunocompetence, or pulmonary function.CONCLUSION:
No clinically important differences in cardiovascular and systemic response were observed between patients undergoing CO2 or gasless laparoscopy for colonic disease.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumoperitônio Artificial
/
Respiração
/
Dióxido de Carbono
/
Monitorização Intraoperatória
/
Laparoscopia
/
Colo
/
Hemodinâmica
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Surg
Ano de publicação:
1999
Tipo de documento:
Article
País de afiliação:
Dinamarca