Pulmonary function in women: comparative analysis of conventional versus single-port laparoscopic cholecystectomy.

Marisa De Carvalho Borges,Paulo Fernando De Oliveira,Alex Augusto Da Silva,Eduardo Crema,Aline Borges Gouvea,Stephania Ferreira Borges Marcacini

doi:10.1590/0100-6991e-20181652

Abstract

to evaluate the pulmonary function of women submitted to conventional and single-port laparoscopic cholecystectomy. forty women with symptomatic cholelithiasis, aged 18 to 70 years, participated in the study. We divided the patients into two groups: 21 patients underwent conventional laparoscopic cholecystectomy, and 19, single-port laparoscopic cholecystectomy. We assessed pulmonary function through forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and the FEV1/FVC ratio, measured before and 24 hours after the procedure. in both groups, FVC and FEV1 were lower in the postoperative period than those obtained in the preoperative period, with a greater reduction in the group undergoing conventional laparoscopic cholecystectomy. Regarding the FEV1/FVC (%) values, there was no statistically significant difference in any of the groups or times analyzed. there was a greater decline in FVC and FEV1 in the postoperative group of patients submitted to conventional laparoscopic cholecystectomy.

Highlights

Despite the excellent results of laparoscopic surgery, the intention of having a ‘no-scar’ surgery did not stop
We studied 40 women with symptomatic cholelithiasis, aged between 18 and 70 years, divided into two groups: 21 patients submitted to conventional laparoscopic cholecystectomy, and 19, to single-port laparoscopic cholecystectomy
Some surgical procedures interfere with pulmonary mechanics and tend to develop restrictive ventilatory changes, with a reduction in FEV1 and forced vital capacity (FVC), which may reach approximately 40 to 50% of the preoperative value and remain reduced for at least one to two weeks[7]

Summary

Introduction

Despite the excellent results of laparoscopic surgery, the intention of having a ‘no-scar’ surgery did not stop. In 1985, Mühe[1] performed the first laparoscopic cholecystectomy by means of a multicanal single-port trocar with only one incision in Germany. The “competition” between standard laparoscopy with three or four trocars, NOTES and single incision laparoscopy led to the rapid development of special single-port trocars[2]. Abdominal surgical procedures may alter lung function, reducing lung volumes and capacities and, impairing gas exchange and increasing hospitalization time. Manipulation of the abdominal cavity, as explained by Ribeiro et al.[5], leads to a decrease in pulmonary volumes and capacities, which may result in hypoxemia and atelectasis due to diaphragmatic dysfunction. Diaphragmatic paresis associated with the induced pneumoperitoneum may lead to atelectasis in bases, resulting in a collapse of alveolar ventilation, with alteration in ventilation-perfusion or shunt causing hypoxemia[6]

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Methods

Conclusion