Chest physiotherapy does not improve the outcome in laparoscopic fundoplication and vertical-banded gastroplasty

Abstract

Background: Chest physiotherapy is a common practice after open reflux and obesity surgery. It is now possible to perform fundoplication and vertical banded gastroplasty (VBG) by the laparoscopic technique. The aim of this study was to evaluate in a prospective, randomized, controlled trial whether chest physiotherapy affects the postoperative course.

Method: A series of 40 patients underwent laparoscopic fundoplication; another 40 underwent laparoscopic VBG. Twenty patients in each series received prophylactic chest physiotherapy; the other 20 served as control patients and were not given any information or training.

Results: Postoperatively, all patients had a significant reduction in respiratory function, measured as oxygen saturation, forced vital capacity, and peak expiratory flow, but the differences between the groups within each series were not significant. Postoperatively, one patient in the VBG treatment group had hypoxemia (SaO₂ <92%) versus two control patients. One control patient developed postoperative pneumonia.

Conclusions: This study indicates that routine chest physiotherapy is not necessary in patients undergoing laparoscopic upper gastrointestinal surgery, such as fundoplication and VBG.