RT Journal Article
SR Electronic
T1 Comparison of the impact of laparoscopy and laparotomy on thoracoabdominal mechanics
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1186
VO 40
IS Suppl 56
A1 Denise de Moraes Paisani
A1 Adriana Claudia Lunardi
A1 Desiderio Cano Porras
A1 Celso Ricardo Fernandes Carvalho
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P1186.abstract
AB Abdominal surgery impairs respiratory system during the postoperative period. Laparoscopies (LPC) and laparotomies (LPT) are the most used surgical procedures; however, there is not enough evidence regarding the differences of both surgeries on the respiratory mechanics. Objective: To compare the effect of laparoscopy and laparotomy surgeries on thoracoabdominal mechanics. Methods: This prospective study enrolled 19 consecutive patients, 9 undergoing LPC and 10 LPT (56±9 yrs, BMI=24±4 Kg/m2) that performed chest wall kinematics analysis (optoelectronic plethysmography) before and 2 days after surgery. Patients were evaluated during quiet and deep breathing. Two way repeated measures ANOVA and post hoc Student Newman Keuls test were performed and significance level was set at 5%. Results: Surgical duration was similar between both groups (LPC=229.4±96 vs. LPT=275.0±104min; p>0.05). After LPC and LPT surgeries, patients presented similar decrease in chest wall volume at deep breath (respectively, 1.5±0.3 vs. 1.2±0.4L and 1.6±0.5 vs. 1.1±0.3L; p>0.05). However, LPT induced a decrease in ABD volumes and a greater increase in URC and compared to LPC (respectively, URC 48% vs. 39% and ABD 23% vs. 28%; p<0.001), after surgery. Conclusions: Although LPC and LPT promote similar decrease on pulmonary volumes in the postoperative period, LPT induces a greater apical breathing pattern.