title: A prospective clinical study evaluating the development of bowel wall edema during laparoscopic and open visceral surgery.
abstract: BACKGROUND
  To examine bowel wall edema development in laparoscopic and open major visceral surgery.
  
  
  METHODS
  In a prospective study, 47 consecutively operated patients with gastric and pancreatic resections were included. Twenty-seven patients were operated in a conventional open procedure (open group) and 20 in a laparoscopic fashion (lap group). In all procedures, a small jejunal segment was resected during standard preparation, of which we measured the dry-wet ratio. Furthermore, HE staining was performed for measuring of bowel wall thickness and edema assessment.
  
  
  RESULTS
  Mean value (±std) of dry-wet ratio was significantly lower in the open than in the lap group (0.169 ± 0.017 versus 0.179 ± 0.015; p = 0.03) with the same amount of fluid administration in both groups and a longer infusion interval during laparoscopic surgery. Subgroup analyses (only pancreatic resections) still showed similar results. Histologic examination depicted a significantly larger bowel wall thickness in the open group.
  
  
  CONCLUSIONS
  Laparoscopic surgery does not seem to lead to the bowel wall edema observed to occur in open surgery regardless of the degree of intravenous fluid administration, thus supporting its use even in major visceral surgery.
authors.affiliation: Department of General and Digestive Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany, goran.marjanovic@uniklinik-freiburg.de.
authors.forename: Goran
authors.initials: G
authors.lastname: Marjanovic
authors.forename: Jasmina
authors.initials: J
authors.lastname: Kuvendziska
authors.forename: Philipp Anton
authors.initials: PA
authors.lastname: Holzner
authors.forename: Torben
authors.initials: T
authors.lastname: Glatz
authors.forename: Olivia
authors.initials: O
authors.lastname: Sick
authors.forename: Gabriel
authors.initials: G
authors.lastname: Seifert
authors.forename: Birte
authors.initials: B
authors.lastname: Kulemann
authors.forename: Simon
authors.initials: S
authors.lastname: Küsters
authors.forename: Jodok
authors.initials: J
authors.lastname: Fink
authors.forename: Sylvia
authors.initials: S
authors.lastname: Timme
authors.forename: Ulrich Theodor
authors.initials: UT
authors.lastname: Hopt
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wellner
authors.forename: Tobias
authors.initials: T
authors.lastname: Keck
authors.forename: Wojciech Konrad
authors.initials: WK
authors.lastname: Karcz
mesh_terms: D004487:Edema / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis*; D007583:Jejunum / Q000473:pathology*; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D011446:Prospective Studies