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Randomized controlled trial comparing the effects of usual gas release, active aspiration, and passive‐valve release on abdominal distension in patients who have undergone laparoscopic cholecystectomy
Author(s) -
Tuvaya Warisara,
Silchai Potchanee,
Sirivatanauksorn Yongyut,
Visavajarn Porntita,
Pungdok Jaruwan,
Tonklai Sununtha,
Akaraviputh Thawatchai
Publication year - 2018
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12451
Subject(s) - medicine , surgery , distension , abdominal distension , anesthesia , abdominal surgery , randomized controlled trial , port (circuit theory) , laparoscopic surgery , laparoscopy , electrical engineering , engineering
Abstract Introduction Residual, intra‐abdominal CO 2 contributes to abdominal distension and pain after laparoscopic surgery. The study was designed to assess recovery after gas release in patients who have undergone laparoscopic cholecystectomy (LC). Methods A total of 142 patients undergoing laparoscopic cholecystectomy were randomly divided into three groups: (i) group 1 (control group), gas release from the surgical wound without port release ( n = 47); (ii) group 2, active gas aspiration via a subdiaphragmatic port ( n = 48); and (iii) group 3, passive‐valve release via a subdiaphragmatic port valve opening ( n = 47). Abdominal distension and shoulder pain levels were assessed postoperatively. Results The active aspiration group had significantly reduced postoperative abdominal distensions at 30 min, 4, and 24 h compared with the control group (50.0% vs 80.9%, 43.8% vs 76.6%, 33.3% vs 57.4%, respectively; P < 0.05). Similarly, the passive‐valve release group had significantly reduced postoperative abdominal distensions at 4 and 24 h compared with the control group (51.1% vs 76.6%, 57.4% vs 36.2%; P < 0.05). Both intervention groups had significantly reduced postoperative shoulder pain at 4 and 24 h compared with the control group ( P < 0.001). In addition, the postoperative ambulation times for the active aspiration group were significantly shorter than those for the control and passive‐valve release groups ( P < 0.001). Conclusion Releasing residual CO 2 from the intra‐abdominal cavity at the end of laparoscopic cholecystectomy by either the active aspiration or passive‐valve release technique is an effective way to reduce postoperative abdominal distension and shoulder pain.