Low vs. conventional intra-abdominal pressure in laparoscopic colorectal surgery : a prospective cohort study
Hamid, Mohammed Zaman, Shafquat Mostafa, Omar Ezzat Saber Deutsch, Alex Bird, Jonty Kawesha, Anthony Reay, Michael Banga, Irmeet Williams, Anna Waterland, Peter
Hamid, Mohammed
Zaman, Shafquat
Mostafa, Omar Ezzat Saber
Deutsch, Alex
Bird, Jonty
Kawesha, Anthony
Reay, Michael
Banga, Irmeet
Williams, Anna
Waterland, Peter
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Affiliation
Dudley Group NHS Foundation Trust; Walsall Healthcare NHS Trust; University Hospital of Derby and Burton NHS Foundation Trust; University of Birmingham; Aston University Medical School
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Publication date
2024-12-18
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Abstract
A total of 120 patients were included of which 69 (57.5%) were male. Median age and BMI of the cohort was 67 years (51-75 years) and 27 kg/m2 (24-32 kg/m2), respectively. 61 (50.8%) patients were categorised as an ASA grade 3. Two (1.7%) patients had diverticular disease; 31 (25.9%) had IBD, and 87 (72.4%) were operated on for colonic malignancy. Low IAP (8mmHg) was used in 53 (44.2%) cases, whilst the remainder (55.8%) had IAP set at 15mmHg (conventional). Low-pressure surgery was associated with improved intraoperative lung compliance (p < 0.001) and peak inspiratory pressures up to 6 h (p < 0.001); reduced analgesic requirement (p ≤ 0.028), and decreased postoperative pain both at rest (p = 0.001) and on exertion (p < 0.001). Moreover, low IAP was associated with an earlier time to pass flatus postoperatively (p = 0.047) with no significant difference in length of hospital stay (p = 0.574). Additionally, no significant difference was observed between the groups for outcomes including median operating time (p = 0.089), conversion to open surgery (p = 0.056), overall complication rate (p = 0.102), and 90-day mortality (p = 0.381).
Citation
Hamid M, Zaman S, Mostafa OES, Deutsch A, Bird J, Kawesha A, Reay M, Banga I, Williams A, Waterland P, Akingboye A. Low vs. conventional intra-abdominal pressure in laparoscopic colorectal surgery: a prospective cohort study. Langenbecks Arch Surg. 2024 Dec 18;410(1):12. doi: 10.1007/s00423-024-03579-3. PMID: 39692883.
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Article