BİLDİRİLER

BİLDİRİ DETAY

Ezgi YILDIRIM, Ayşegül GÜVEN, Derya GÖKMEN, Menekşe ÖZÇELİK
FACTORS INFLUENCING ABDOMINAL COMPLIANCE DURING CO2 INSUFFLATION IN PATIENTS UNDERGOING LAPAROSCOPIC ABDOMINAL SURGERY
 
Background: During laparoscopic surgery, pneumoperitoneum is achieved by insufflating carbon dioxide (CO2) gas into the abdominal cavity to create a safe working space. Pneumoperitoneum-induced elevation in intra-abdominal pressure (IAP) can result in various complications. Abdominal compliance (AC), represents the slope of the P-V curve of the abdominal cavity and is a measure of the ease of abdominal dilatation, is important to balance between surgical safety and complications. The aim of this study was to determine the effect of demographic and anatomic variables on AC. Methods: The study included 90 patients who underwent laparoscopic abdominal surgery. Subcutaneous adipose tissue and abdominal muscle thickness were measured ultrasonographically. Mean AC was calculated during insufflation using the formula (ΔV/ΔP). The relationship between demographic and anatomic variables and AC was investigated. Results: There was no significant correlation between AC and BMI, abdominal muscle thickness, and subcutaneous adipose tissue thickness. AC was higher in men, the elderly, and women with a history of pregnancy and lower in patients with a history of abdominal surgery. No statistically significant correlation was found between ASA score and AC. Conclusion: The findings of this study emphasize that morbid obesity, one of the most feared comorbidities in laparoscopic surgery, and additionally developed abdominal muscles are not indicative of low AC. However, gender, age, history of pregnancy, and previous abdominal surgery influence AC during laparoscopic surgery. Consideration of these factors during preoperative assessment may allow prediction of patients with low AC and use of individualized IAP during pneumoperitoneum, thus improving surgical outcomes and patient safety.(This study is derived from the "Medical Specialization Dissertation" of the first author and approved by Ankara University Faculty of Medicine Human Research Ethics Committee (protocol code: İ07-432-22, approved on August 04, 2022) ORCID ID: 0000-0002-7556-3524, 0000-0002-7837-7655, 0000-0001-6266-3035, 0000-0001-5893-8577).

Anahtar Kelimeler: Abdominal Compliance, Laparoscopic Surgery, Intra-Abdominal Pressure



 


Keywords: