Effects of laparoscopic cholecystectomy on global respiratory muscle strength. 1996

N Rovina, and D Bouros, and N Tzanakis, and M Velegrakis, and S Kandilakis, and F Vlasserou, and N M Siafakas
Department of Thoracic Medicine, University General Hospital of Crete, University of Crete Medical School, Greece.

Laparoscopic cholecystectomy has a better postoperative outcome than the traditional open technique, which has been shown to significantly affect respiratory muscle function. The aim of this study was to investigate the effects of laparoscopic surgery on respiratory function, and particularly that of the respiratory muscles. Respiratory muscle strength was assessed in 26 patients who underwent laparoscopic cholecystectomy and in 25 who underwent open cholecystectomy by measuring mouth pressure during maximum static inspiratory (PImax) and expiratory (PEmax) efforts. PImax, PEmax, and blood gases were measured 24 h preoperatively (-24 h) as well as 24 h (+24 h) and 48 h (+48 h) postoperatively. FEV1 and FVC were measured at -24 h and +48 hr, and the ratio of FEV1 to FVC (FEV1/FVC) was calculated. PImax decreased at +24 h and +48 h in both groups, but this decrease was significantly greater in the patients who had open surgery, (p < 0.01, and p < 0.005, respectively). Similarly, PEmax was significantly smaller in the open- than in the laparoscopic-surgery group (p < 0.0001) at +48 h. Spirometric indices showed a more severe restrictive defect at +48 h after open surgery than after laparoscopy (p = 0.01). The arterial oxygen tension (PaO2) was significantly greater in the laparoscopic- than in the open-surgery group at +24 h (p < 0.007). Laparoscopic cholecystectomy caused smaller decreases in respiratory muscle strength than did open surgery. This accords with the hypothesis of phrenic nerve inhibition during open surgery. The results are of clinical importance, since they may explain the different outcomes with the two techniques.

UI MeSH Term Description Entries
D008297 Male Males
D008365 Manometry Measurement of the pressure or tension of liquids or gases with a manometer. Tonometry,Manometries
D011187 Posture The position or physical attitude of the body. Postures
D012129 Respiratory Function Tests Measurement of the various processes involved in the act of respiration: inspiration, expiration, oxygen and carbon dioxide exchange, lung volume and compliance, etc. Lung Function Tests,Pulmonary Function Tests,Function Test, Pulmonary,Function Tests, Pulmonary,Pulmonary Function Test,Test, Pulmonary Function,Tests, Pulmonary Function,Function Test, Lung,Function Test, Respiratory,Function Tests, Lung,Function Tests, Respiratory,Lung Function Test,Respiratory Function Test,Test, Lung Function,Test, Respiratory Function,Tests, Lung Function,Tests, Respiratory Function
D012132 Respiratory Muscles These include the muscles of the DIAPHRAGM and the INTERCOSTAL MUSCLES. Ventilatory Muscles,Respiratory Muscle,Muscle, Respiratory,Muscle, Ventilatory,Muscles, Respiratory,Muscles, Ventilatory,Ventilatory Muscle
D002763 Cholecystectomy Surgical removal of the GALLBLADDER. Cholecystectomies
D003627 Data Interpretation, Statistical Application of statistical procedures to analyze specific observed or assumed facts from a particular study. Data Analysis, Statistical,Data Interpretations, Statistical,Interpretation, Statistical Data,Statistical Data Analysis,Statistical Data Interpretation,Analyses, Statistical Data,Analysis, Statistical Data,Data Analyses, Statistical,Interpretations, Statistical Data,Statistical Data Analyses,Statistical Data Interpretations
D005069 Evaluation Studies as Topic Works about studies that determine the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. Critique,Evaluation Indexes,Evaluation Methodology,Evaluation Report,Evaluation Research,Methodology, Evaluation,Pre-Post Tests,Qualitative Evaluation,Quantitative Evaluation,Theoretical Effectiveness,Use-Effectiveness,Critiques,Effectiveness, Theoretical,Evaluation Methodologies,Evaluation Reports,Evaluation, Qualitative,Evaluation, Quantitative,Evaluations, Qualitative,Evaluations, Quantitative,Indexes, Evaluation,Methodologies, Evaluation,Pre Post Tests,Pre-Post Test,Qualitative Evaluations,Quantitative Evaluations,Report, Evaluation,Reports, Evaluation,Research, Evaluation,Test, Pre-Post,Tests, Pre-Post,Use Effectiveness
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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