A Simple Method of Reducing Residual Intraperitoneal Carbon Dioxide After Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled Study

Lee, Jun Suh; Kim, Eun Young; Lee, Soo Ho; Han, Jae Hyun; Park, Sung Kyun; Na, Gun Hyung; You, Young Kyoung; Kim, Dong Goo; Hong, Tae Ho

doi:10.1089/lap.2014.0041

Cited by 11 publications

(4 citation statements)

References 14 publications

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“…Another study showed that abdominal wall-lift procedures for LC can decrease the incidence of PLSP, without using any inflating gas during surgery 30 . Notably, some small clinical studies showed active pneumoperitoneum gas aspiration to be effective in reducing PLSP one day post-LC 31 – 33 . Therefore, the role of a drain in reducing PLSP is similar to maneuvers that evacuate CO 2 after laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

To drain or not to drain: the association between residual intraperitoneal gas and post-laparoscopic shoulder pain for laparoscopic cholecystectomy

Yang

Chang

Wei

et al. 2021

Sci Rep

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Residual intra-peritoneal gas may be associated with post-laparoscopic shoulder pain (PLSP), which is a frequently and disturbance compliant after surgery. Herein, we aimed to examine whether expiring residual gas via a surgical drain reduces the frequency and intensity of PLSP in the first day after laparoscopic cholecystectomy. 448 participants were enrolled in this prospective cohort study. The incidence and severity of PLSP after surgery were recorded. Of these, the cumulative incidence of PLSP in the drain group was lower particularly at the 12th postoperative hour (18.3% vs. 27.6%; P = 0.022), 24th postoperative hour (28.8% vs. 38.1%; P = 0.039), and throughout the first postoperative day (P = 0.035). The drain group had less severe PLSP (crude Odds ratio, 0.66; P = .036). After adjustment using inverse probability of treatment weighting, the drain group also had a significant lower PLSP incidence (adjusted hazard ratio = 0.61, P < 0.001), and less severe PLSP (adjusted odds ratio = 0.56, P < 0.001). In conclusion, the maneuver about passive force to expel residual gas, surgical drain use, contributes to reduce the incidence and severity of PLSP, suggesting that to minimize residual gas at the end of surgery is useful to attenuate PLSP.

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Section: Discussionmentioning

confidence: 99%

To drain or not to drain: the association between residual intraperitoneal gas and post-laparoscopic shoulder pain for laparoscopic cholecystectomy

Yang

Chang

Wei

et al. 2021

Sci Rep

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show abstract

“…In another study, postoperative pain levels and the amount of gas remaining in the abdomen following laparoscopy were investigated in patients with and without active aspiration. In the results obtained, the amount of residual gas in the abdomen and the postoperative scores were found to be lower in the patients with active aspiration (21). There are studies in literature which have researched the effects of the creation of pneumoperitoneum on adhesion formation.…”

Section: The Effects Of Carbon Dioxide Pneumoperitoneum On the Peritomentioning

confidence: 87%

Karbondioksit ile Oluşturulan Pnömoperitoneumun Periton Yapısı Üzerine Etkileri

Saricik¹,

Koca²,

Tarhan³

2017

SDÜ Sağlık Bilimleri Dergisi

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Laparoskopik ameliyatların uygulanmaya başlamasıyla beraber pnömoperiton oluşturmak için birçok gaz denenmiştir. Bunlar arasında halen en yaygın kullanımda olan karbondioksit gazıdır. Karbondioksit ile oluşturulan pnömoperiton laparoskopik ameliyatlarda cerrahlara uygun alan oluşturmasına rağmen peritoneal yapı üzerinde birtakım istenmeyen değişikliklere de sebep olmaktadır. Bu yan etkilerden bazıları kaçınılmaz olmasına rağmen bazı yan etkilerde uygulama şekline bağlı değişiklik gösterebilmektedir. Karbondioksit ile oluşturulan pnömoperitonun peritoneal yapı üzerine etkilerine ilişkin literatürdeki yapılan deneysel ve klinik çalışmalar dikkate alınarak bu derleme hazırlandı. Pnomöperiton oluşumu peritoneal çevreyi ve dolayısıyla organizmayı etkiler. Bu etkilenim intraabdominal basınç artışı, karbondioksitin lokal peritoneal destrüktif etkileri, karbondioksit emilimi ve kimyasal metabolik değişimler gibi sebeplerle olmaktadır. Özellikle ek hastalığı olan ya da obez hastalarda pnömoperitonun yaptığı etkiler hakkında farkındalığa sahip olunması önemlidir. Bu farkındalık hastaların pnömoperitonun yaptığı istenmeyen değişikliklerden etkilenimini azaltacağı kanısındayız

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“…Pain scores are subjective parameters, while the volume of residual intraperitoneal air is more objective. Lee et al [ 18 ] investigated whether active suction decreases residual intraperitoneal gas and whether residual gas decreases pain scores. They performed a prospective randomized controlled study to investigate whether active gas suction reduces the intraperitoneal residual carbon dioxide volume and analyzed the effect of active gas suction on postoperative pain after laparoscopic cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

“…They performed a prospective randomized controlled study to investigate whether active gas suction reduces the intraperitoneal residual carbon dioxide volume and analyzed the effect of active gas suction on postoperative pain after laparoscopic cholecystectomy. [ 18 ] They found that active suction significantly decreased the residual intraperitoneal gas volume and postoperative pain after laparoscopic surgery. In another randomized controlled study, the effect of active gas aspiration on postoperative shoulder pain relief after diagnostic laparoscopy was significantly superior to that of simple gas evacuation and was not associated with any adverse events.…”

Section: Discussionmentioning

confidence: 99%

Residual intraperitoneal carbon dioxide gas following laparoscopy for adnexal masses: Residual gas volume assessment and postoperative outcome analysis

2022

Medicine

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Free residual gas after laparoscopy may cause shoulder pain, decreasing patient satisfaction with the procedure. We analyzed the correlation between postoperative residual carbon dioxide gas and shoulder pain, explored the peri-and postoperative factors associated with residual carbon dioxide and determined the effects of the use of a drainage tube. A cohort of 326 patients who underwent laparoscopic adnexal surgery between March 2005 and June 2018 at a teaching hospital in Korea was retrospectively analyzed through a medical records review. The enrolled patients were divided into 1-, 2-, and 3-port groups. The right volume, left volume, and total volume of residual gas were calculated using a formula based on measurements obtained from chest X-rays. Continuous variables were compared using Student t tests. Categorical variables were compared with the chi-square test or Kruskal-Wallis test. The total volumes of postoperative residual carbon dioxide gas were significantly different between the 1and 2-port groups and between the 1-and 3-port groups (157.3 ± 179.2 vs 25.1 ± 92.3 mL and 157.3 ± 179.2 vs 12.9 ± 36.4 mL, respectively). The volume of residual gas and the time to the first passage of gas were positively correlated. The total volume of residual gas was more strongly correlated with the operative wound pain score than with the shoulder pain score. Additionally, the pre-and postoperative white blood cell counts, postoperative hospitalization duration, residual carbon dioxide volume, and shoulder pain score were significantly different between patients with and without a drainage tube. Although the volume of residual gas was not correlated with the shoulder pain score, the author found that both were lower in patients with a drainage tube than in those without, indicating that a drainage tube could be safely used to decrease residual gas volume and the shoulder pain score without increasing the risk of postoperative infection. Abbreviations: BMI = body mass index, Hb = hemoglobin, VRS = verbal rating scale, WBC = white blood cell.

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A Simple Method of Reducing Residual Intraperitoneal Carbon Dioxide After Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled Study

Abstract: Active gas suction is a very simple procedure that is safe and feasible. Performing this procedure significantly decreases the residual intraperitoneal gas volume and postoperative pain after laparoscopic surgery.

Cited by 11 publications

References 14 publications

To drain or not to drain: the association between residual intraperitoneal gas and post-laparoscopic shoulder pain for laparoscopic cholecystectomy

To drain or not to drain: the association between residual intraperitoneal gas and post-laparoscopic shoulder pain for laparoscopic cholecystectomy

Karbondioksit ile Oluşturulan Pnömoperitoneumun Periton Yapısı Üzerine Etkileri

Residual intraperitoneal carbon dioxide gas following laparoscopy for adnexal masses: Residual gas volume assessment and postoperative outcome analysis

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