[Changes in cardio-pulmonary function during laparoscopic colectomy and postoperative quality of life--comparison with laparotomy].
BACKGROUND
We investigated whether laparoscopic colectomy would affect the degree of respiratory and circulatory changes during surgery and could improve postoperative quality of life (QOL) as compared with laparotomy.


METHODS
Fifty-one patients (ASA 1-3) scheduled for elective colectomy under general anesthesia with epidural anesthesia were enrolled in the study. All patients were divided into two groups (laparoscopic group: n = 33 and laparotomy group: n = 18) by surgical indication. Respiratory functions and hemodynamic changes were measured during surgery. Postoperative complications, pain scores, the time to start of walking and the period of hospital stay were examined. The serum concentrations of inflammatory cytokines (IL-6, IL-1 ra) and KL-6 were measured perioperatively.


RESULTS
It was demonstrated that pneumoperitoneum and postural tilt had a bad influence on respiratory functions especially on pulmonary compliance and a-ET(D)co2 in laparoscopic group. The serum concentrations of inflammatory cytokines were significantly lower and the number of rescue for postoperative pain were less in laparoscopic group. The patients in laparoscopic group could begin to walk and leave hospital earlier after surgery.


CONCLUSIONS
Severe complication did not occurr in both groups during the perioperative period. Laparoscopic surgery could improve postoperative QOL.
Kobayashi
Takashi
T
Department of Anesthesiology, School of Medicine, Iwate Medical University, Morioka 020-8505.
Nagata
Hirofumi
H
Kadosaki
Mamoru
M
Ohtsuka
Kouki
K
D000368:Aged; D000758:Anesthesia / Q000379:methods; D000768:Anesthesia, General; D003082:Colectomy / Q000379:methods*; D017558:Elective Surgical Procedures; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D012119:Respiration