Assessment of pulmonary function in patients before and after laparoscopic and open esophagogastric surgery.
BACKGROUND
Laparoscopy is a technique used in various surgical procedures. Few studies in the literature compare stress between laparoscopic and open surgery used for esophagogastric surgical procedures. Pulmonary function is known to be significantly affected in open surgeries, increasing postoperative morbidity and mortality. The current study aimed to assess pulmonary function in patients before and after open and laparoscopic esophagogastric surgery.


METHODS
For this study, 75 patients were divided into two groups: 50 patients undergoing laparoscopy and 25 patients undergoing open surgery. The following parameters were determined by spirometry before and after surgery: forced expiratory volume in the first second (FEV(1)), forced vital capacity (FVC), and forced expiratory flow in the midexpiratory phase (FEF(25-75%)).


RESULTS
A decrease in FEV(1,) FVC, and FEF((25-75%)) was observed in the two groups on postoperative days 2, 3, and 4, as compared with the preoperative period. Likewise, FEV(1) and FVC showed a significant reduction on postoperative days 2, 3, and 4 in the patients who underwent to open surgery, but only on the day 2 in those who underwent to laparoscopic surgery. A significant decrease in FEF((25-75%)) was observed only on postoperative day 2 in the group that underwent open surgery. Significant differences in FEV(1) between the groups were observed on postoperative days 2, 3, and 4. No significant difference in FVC was noted between the groups, and a difference in FEF((25-75%)) was observed only on postoperative day 4.


CONCLUSIONS
Postoperative pulmonary dysfunction was more important for the patients undergoing open surgery than for those undergoing laparoscopic surgery.
Crema
E
E
The Academic Unit of Surgery, Federal School of Medicine of Triângulo Minerio, Uberaba, MG, Brazil. eduardocremafmtm@mednet.com.br
Benelli
A G
AG
Silva
A V
AV
Martins
A J
AJ
Pastore
R
R
Kujavao
G H
GH
Silva
A A
AA
Santana
J R
JR
D013505:Digestive System Surgical Procedures; D004931:Esophageal Achalasia / Q000503:physiopathology / Q000601:surgery*; D005541:Forced Expiratory Volume; D005764:Gastroesophageal Reflux / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008450:Maximal Midexpiratory Flow Rate; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D014797:Vital Capacity