Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 13, Issue 6, pp 567–570 | Cite as

The effects of isothermic and hypothermic carbon dioxide pneumoperitoneum on respiratory function test results

  • Ali Uzunkoy
  • Abdullah Ozgonul
  • Erkan Ceylan
  • Mehmet Gencer
Article

Abstract

Background/Purpose

This study investigated the effects of isothermic and hypothermic carbon dioxide, used for pneumoperitoneum during laparoscopic cholecystectomy, on respiratory function test results.

Methods

Thirty patients who underwent elective laparoscopic cholecystectomy were enrolled in this prospective randomized study. The patients were divided into two groups. Carbon dioxide at 37 °C (isothermic) was used in the isothermic group, and carbon dioxide at 21 °C (hypothermic) was used in the hypothermic group. Respiratory function tests were performed in the preoperative period and at 12 h after the operation.

Results

Mean forced vital capacity (FVC), forced expiratory volume (FEV1), maximum peak expiratory flow (PEF), and the FEV1/FVC ratio were significantly higher in the isothermic group than in the hypothermic group (P < 0.05).

Conclusions

Using isothermic carbon dioxide for pneumoperitoneum has fewer negative effects than hypothermic carbon dioxide on respiratory function tests results. Isothermic carbon dioxide may be preferable for patients with respiratory problems.

Key words

Laparoscopy Pneumoperitoneum Hypothermia Isothermia Pulmonary function test 

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References

  1. 1.
    Heikkinen, TJ, Haukipuro, K, Sorasto, A, Autio, R, Sodervik, H, Makela, H,  et al. 2000Short-term symptomatic outcome and quality of life after laparoscopic versus open Nissen fundoplication: a prospective randomized trialInt J Surg Investig2339PubMedGoogle Scholar
  2. 2.
    Kano, N, Yamakawa, T, Ishikawa, Y, Sakai, S, Honda, H, Kasugai, H 1994Laparoscopic cholecystectomy: key technical points to prevent bile duct injuryJ Hepatobiliary Pancreat Surg13148CrossRefGoogle Scholar
  3. 3.
    Laine, S, Rantala, A, Gullichsen, R, Ovaska, J 1997Laparoscopic vs conventional Nissen fundoplication. A prospective randomized studySurg Endosc114414PubMedCrossRefGoogle Scholar
  4. 4.
    Ammori, BJ, Davides, D, Vezakis, A, Martin, IG, Larvin, M, Smith, S,  et al. 2003Day-case laparoscopic cholecystectomy: a prospective evaluation of a 6-year experienceJ Hepatobiliary Pancreat Surg103038PubMedCrossRefGoogle Scholar
  5. 5.
    Puttick, MI, Scott-Coombes, DM, Dye, J, Nduka, CC, Menzies-Gow, NM, Mansfield, AO,  et al. 1999Comparison of immunologic and physiologic effects of CO2 pneumoperitoneum at room and body temperaturesSurg Endosc135725PubMedCrossRefGoogle Scholar
  6. 6.
    Jacobs, VR, Morrison, JE,Jr 2001Warmed insufflation carbon dioxide gas for laparoscopic cholecystectomySurg Endosc1512445PubMedCrossRefGoogle Scholar
  7. 7.
    Jacobs, VR, Morrison, JE,Jr, Mettler, L, Mundhenke, C, Jonat, W 1999Measurement of CO2 hypothermia during laparoscopy and pelviscopy: how cold it gets and how to prevent itJ Am Assoc Gynecol Laparosc628995PubMedCrossRefGoogle Scholar
  8. 8.
    Menke, H, John, KD, Klein, A, Lorenz, W, Junginger, T 1992Perioperative risk assessment with the ASA classification. A prospective study of morbidity and mortality in various ASA classes in 2937 patients in general surgeryChirurg63102934PubMedGoogle Scholar
  9. 9.
    Hazebroek, EJ, Haitsma, JJ, Lachmann, B, Steyerberg, EW, de Bruin, RW, Bouvy, ND,  et al. 2002Impact of carbon dioxide and helium insufflation on cardiorespiratory function during prolonged pneumoperitoneum in an experimental rat modelSurg Endosc1610738PubMedCrossRefGoogle Scholar
  10. 10.
    Volpino, P, Cangemi, V, D'Andrea, N, Cangemi, B, Piat, G 1998Hemodynamic and pulmonary changes during and after laparoscopic cholecystectomy. A comparison with traditional surgerySurg Endosc1211923PubMedCrossRefGoogle Scholar
  11. 11.
    No authors listed1987Standardization of spirometry — 1987 update. Statement of the American Thoracic SocietyAm Rev Respir Dis136128598Google Scholar
  12. 12.
    Kantorova, I, Svoboda, P, Ochmann, J, Pestal, M, Kozumplik, L, Dolezalova, L 1999Does insufflation of the abdomen in laparoscopic surgery affect acid-base and ventilatory parameters?Rozhl Chir783326PubMedGoogle Scholar
  13. 13.
    Monagle, J, Bradfield, S, Nottle, P 1993Carbon dioxide, temperature and laparoscopic cholecystectomyAust N Z J Surg631869PubMedGoogle Scholar
  14. 14.
    Gass, GD, Olsen, GN 1986Preoperative pulmonary function testing to predict postoperative morbidity and mortalityChest8912735PubMedGoogle Scholar
  15. 15.
    Farley, DR, Greenlee, SM, Larson, DR, Harrington, JR 2004Double-blind, prospective, randomized study of warmed, humidified insufflation and standard carbon dioxide for patients undergoing laparoscopic cholecystectomyArch Surg13973943PubMedCrossRefGoogle Scholar
  16. 16.
    Semm, K, Arp, WD, Trappe, M, Kube, D 1994Pain reduction after pelviclaparoscopic interventions by insufflation of CO2 gas at body temperature (flow-Therme)Geburtshilfe Fraunheilkd543004CrossRefGoogle Scholar
  17. 17.
    Saad, S, Minor, I, Mohri, T, Nagelschmidt, M 2001The clinical impact of warmed insufflation carbon dioxide gas for laparoscopic cholecystectomySurg Endosc1512445CrossRefGoogle Scholar
  18. 18.
    Slim, K, Bousquet, J, Kwiatkowski, F, Lescure, G, Pezet, D, Chipponi, J 1999Effect of CO2 gas warming on pain after laparoscopic surgery: a randomized double-blind controlled trialSurg Endosc1311104PubMedCrossRefGoogle Scholar
  19. 19.
    Wills, VL, Hunt, DR, Armstrong, A 2001A randomized controlled trial assessing the effect of heated carbon dioxide for insufflation on pain and recovery after laparoscopic fundoplicationSurg Endosc1516670PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Ali Uzunkoy
    • 1
  • Abdullah Ozgonul
    • 1
  • Erkan Ceylan
    • 2
  • Mehmet Gencer
    • 2
  1. 1.Department of Surgery, Faculty of MedicineHarran UniversitySanliurfaTurkey
  2. 2.Department of Chest Diseases, Faculty of MedicineHarran UniversitySanliurfaTurkey

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