Chest Physiotherapy in Open and Laparoscopic Abdominal Surgery

Abstract

Chest physiotherapy has undergone considerable changes during the last two decades. The purpose of this paper was to review studies on the effects of chest physiotherapy in open and laparoscopic abdominal surgery. Forty-four papers were reviewed, comparing different chest physiotherapeutic interventions in open abdominal surgery; 15 of these trials had an untreated control group. The results were difficult to interpret, as the study designs were not comparable with different treatment criteria for post-operative pulmonary complications, surgery performed and categories of patients. However, the results showed the beneficial effects of breathing exercises in preventing post-operative pulmonary complications, especially in high-risk patients. It was found that laparoscopic procedures impair post-operative respiratory function considerably less than open surgery. One trial published on the effects of physiotherapy in laparoscopic surgery found that routine treatment is not necessary after upper gastro-intestinal procedures such as fundoplication and vertical banded gastroplasty.