Pulmonary Function Following Laparoscopic or Conventional Colorectal Resection

Schwenk, W.

doi:10.1001/archsurg.134.1.6

Cited by 164 publications

(89 citation statements)

References 42 publications

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“…As expected based on the literature, a postoperative restrictive respiratory deficit, characterized by proportional reductions in FEV 1 and FVC values with relative preservation of the FEV 1 /FVC ratio, 4,[10][11][12]14,22 was observed for all patients in the current investigation. Vital capacity was reduced by approximately 35% on POD 1 for both groups, with no significant improvement noted by POD 5.…”

Section: Lung Functionsupporting

confidence: 89%

“…These concerns were alleviated by the fact that the suppression of pulmonary function was of no greater magnitude for patients in the binder group than for those in the no binder group or than that reported elsewhere. 4,10,11,14 Anaesthesia Duration of anaesthesia has previously been demonstrated, in a multivariate-analysis study, to be an important risk factor for the development of PPCs following general elective surgery; 45 specifically, the mean duration of anaesthesia was longer for those with PPCs (480 min) than for those without (309 min). Patients in this study's control group (no binder) underwent anaesthesia for a significantly longer time (p < 0.05).…”

Section: Lung Functionmentioning

confidence: 99%

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The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

Cheifetz¹,

Lucy²,

Overend³

et al. 2010

Physiotherapy Canada

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Purpose: Immobility and pain are modifiable risk factors for development of venous thromboembolism and pulmonary morbidity after major abdominal surgery (MAS). The purpose of this study was to investigate the effect of abdominal incision support with an elasticized abdominal binder on postoperative walk performance (mobility), perceived distress, pain, and pulmonary function in patients following MAS. Methods: Seventy-five patients scheduled to undergo MAS via laparotomy were randomized to experimental (binder) or control (no binder) groups. Sixty (33 male, 27 female; mean age 58 e 14.9 years) completed the study. Preoperative measurements of 6-minute walk test (6MWT) distance, perceived distress, pain, and pulmonary function were repeated 1, 3, and 5 days after surgery. Results: Surgery was associated with marked postoperative reductions (p < 0.001) in walk distance (P75-78%, day 3) and forced vital capacity (35%, all days) for both groups. Improved 6MWT distance by day 5 was greater (p < 0.05) for patients wearing a binder (80%) than for the control group (48%). Pain and symptom-associated distress remained unchanged following surgery with binder usage, increasing significantly (p < 0.05) only in the no binder group. Conclusion: Elasticized abdominal binders provide a non-invasive intervention for enhancing recovery of walk performance, controlling pain and distress, and improving patients' experience following MAS.Key Words: abdominal binder, abdominal surgery, Adapted Symptom Distress Scale, pain, 6-minute walk test RÉ SUMÉObjectif : L'immobilité et la douleur sont des facteurs de risque modifiables dans le dé veloppement de thrombo-embolie veineuse et de morbidité pulmonaire à la suite d'une intervention chirurgicale abdominale majeure. L'objectif de cette é tude é tait d'investiguer les effets d'un soutien de l'incision abdominale à l'aide d'une bande abdominale é lastique sur la marche (mobilité ) postopé ratoire, sur la douleur perç ue, la douleur et la fonction pulmonaire des patients à la suite d'une telle intervention. Mé thode : 75 sujets appelé s à subir une chirurgie abdominale majeure par laparotomie ont é té choisis de fac¸on alé atoire pour faire partie du groupe expé rimental (avec bande abdominale) et d'un groupe de contrô le (sans bande abdominale). De ce nombre, 60 (33 hommes et 27 femmes dont la moyenne d'â ge é tait de 58 e 14,9 ans) ont participé à l'é tude jusqu'à la fin. Les mesures pré opé ratoires comprenaient un test de marche de 6 minutes (TM6), une mesure du degré de douleur perç u, de la douleur et de la fonction pulmonaire; ces mesures ont aussi é té prises aux jours 1, 3 et 5 suivant l'intervention. Ré sultats : L'intervention chirurgicale a é té associé e à des diminutions postopé ratoires marqué es (p < 0.001) dans la distance de marche (P75-78 %, au jour 3) la capacité pulmonaire forcé e (35 %, tous les jours), et ce, pour les deux groupes. L'amé lioration du TM6 au jour 5 a toutefois é té plus importante (p < 0,05) chez les sujets portant une bande abdominale (80 %)...

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Section: Lung Functionsupporting

confidence: 89%

Section: Lung Functionmentioning

confidence: 99%

The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

Cheifetz¹,

Lucy²,

Overend³

et al. 2010

Physiotherapy Canada

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“…Pulmonary function is better preserved when cholecystectomy and colectomy are performed laparoscopically as compared with the open approach[3,4,5]. Therefore it can be hypothesized that postoperative pulmonary complications are lower when the abdominal stage of open transthoracic esophagectomy is performed laparoscopically.…”

Section: Introductionmentioning

confidence: 99%

Results of the Combination of Open Transthoracic Esophagectomy with Laparoscopic Gastric Tube Formation for Esophageal Cancer

Cense¹,

Busch²,

Bemelman³

et al. 2006

Dig Surg

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Background: Postoperative complications after open transthoracic esophagectomy could possibly be reduced if the abdominal phase is performed laparoscopically. The aim of this study was to investigate the feasibility of laparoscopic mobilization of the stomach and gastric tube formation in patients undergoing an open transthoracic esophagectomy for cancer. Methods: Thirteen patients underwent an open transthoracic esophagectomy with extended en bloc lymphadenectomy combined with laparoscopic gastric tube formation. Clinicopathological data were derived from a prospective database and patient files. Results: The median operation time was 484 min (range 347–573) and the median intraoperative blood loss was 1,500 ml (range 250–3,700). In 2 patients the laparoscopic procedure was converted to a laparotomy because of technical difficulties. Median postoperative stay in the ICU was 3 days (range 1–8) and median hospital stay was 29 days (range 12–104). One patient died in the hospital. Postoperatively 3 patients suffered from anastomotic leakage, 5 from pneumonia and 3 from vocal cord palsy. Conclusions: The complication rate was high in this series of patients undergoing an open extended transthoracic esophagectomy with laparoscopic mobilization of the stomach and gastric tube formation. Laparoscopic mobilization of the stomach and gastric tube formation are feasible, but need carefully guided testing before this technique can be applied routinely.

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“…In einer Vielzahl randomisierter Studien konnte gezeigt werden, dass im Vergleich zur konventionellen Technik die laparoskopische Sigmaresektion mit weniger Schmerzen und einem geringerem Schmerzmittelverbrauch [1,2], einer geringeren Beeinträchtigung der Lungenfunktion [3], einer verkürzten post- [8]. Die drei Säulen dieses so genannten «Fast-track»-Konzepts sind die thorakale epidurale Analgesie, der rasche orale Kostaufbau sowie eine forcierte Mobilisation der Patienten bereits am 1. postoperativen Tag.…”

Section: Introductionunclassified

Sigmaresektion bei Divertikulitis – Ist ein «Fast-track»- Konzept notwendige Voraussetzung für die rasche Erholung der Patienten?

Bittner¹

2005

Visc Med

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Die Einführung der laparoskopischen Operationstechnik hat der chirurgischen Therapie der Sigmadivertikulitis neue Impulse gegeben. In der vorliegenden Studie werden die Ergebnisse bei 502 Patienten mit laparoskopischer Sigmaresektion bei Divertikulitis mit denen eines eigenen historischen Kollektivs von 445 konventionell operierten Patienten verglichen. Die Studie belegt, dass die laparoskopische Operation zwar länger dauert, jedoch mit einer signifikant geringeren Morbidität verbunden ist. Die Einführung von Elementen das «Fast-track»- Konzepts in den postoperativen Behandlungsablauf hat zu einer weiteren Verbesserung der Ergebnisse geführt. Es besteht kein Zweifel, dass einer systematischen Schmerztherapie eine mit entscheidende Rolle zukommt. Ob diese jedoch unbedingt durch eine thorakale epidurale Analgesie erfolgen muss, kann zum jetzigen Zeitpunkt noch nicht definitiv entschieden werden. Vor- und Nachteile dieser letztlich invasiven Technik sind durch weitere Studien abzuklären. Vor der frühzeitigen Entlassung des Patienten nach Hause sollte auf jeden Fall die mögliche Gefahr einer Anastomoseninsuffizienz ausgeschlossen sein.

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Pulmonary Function Following Laparoscopic or Conventional Colorectal Resection

Cited by 164 publications

References 42 publications

The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

Results of the Combination of Open Transthoracic Esophagectomy with Laparoscopic Gastric Tube Formation for Esophageal Cancer

Sigmaresektion bei Divertikulitis – Ist ein «Fast-track»- Konzept notwendige Voraussetzung für die rasche Erholung der Patienten?

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