W Schwenk1, B Böhm, A Fügener, J M Müller. 1. Department of General Surgery, Charité, Medical Faculty of the Humboldt University, Berlin, Germany.
Abstract
BACKGROUND:Fifty patients were included in a prospective randomized trial to evaluate the efficacy of intermittent sequential compression (ISC) of the lower extremities in preventing venous stasis during laparoscopic cholecystectomy. METHODS: We treated 25 patients with (+ISC) and 25 without (-ISC) intermittent sequential compression. Peak flow velocity (PFV) and cross-sectional area (CSA) of the right femoral vein were measured by Doppler ultrasound before, during, and after capnopneumoperitoneum with 14 mm Hg. RESULTS: PFV was 26.4 (8.4) cm/s and CSA was 1.03 (0.23) cm2 before pneumoperitoneum was induced. During abdominal insufflation, PFV decreased to 61% of the baseline value in the (-ISC) group but remained unchanged in the (+ISC) group (t = 5.17, df = 42.8, p < 0.01). CSA was 1.06 (0.22) cm2 before insufflation. It increased to 118% of the baseline in the (-ISC) group and to 108% in the (+ISC) group (t = -1.55, df = 47.1, p = 0.13). PFV and CSA returned to baseline values within 5 min after abdominal desufflation. CONCLUSIONS:ISC effectively neutralizes venous stasis during laparoscopic surgery and may decrease the risk of post-operative thromboembolic complication. Therefore, it is recommended for all prolonged laparoscopic procedures.
RCT Entities:
BACKGROUND: Fifty patients were included in a prospective randomized trial to evaluate the efficacy of intermittent sequential compression (ISC) of the lower extremities in preventing venous stasis during laparoscopic cholecystectomy. METHODS: We treated 25 patients with (+ISC) and 25 without (-ISC) intermittent sequential compression. Peak flow velocity (PFV) and cross-sectional area (CSA) of the right femoral vein were measured by Doppler ultrasound before, during, and after capnopneumoperitoneum with 14 mm Hg. RESULTS:PFV was 26.4 (8.4) cm/s and CSA was 1.03 (0.23) cm2 before pneumoperitoneum was induced. During abdominal insufflation, PFV decreased to 61% of the baseline value in the (-ISC) group but remained unchanged in the (+ISC) group (t = 5.17, df = 42.8, p < 0.01). CSA was 1.06 (0.22) cm2 before insufflation. It increased to 118% of the baseline in the (-ISC) group and to 108% in the (+ISC) group (t = -1.55, df = 47.1, p = 0.13). PFV and CSA returned to baseline values within 5 min after abdominal desufflation. CONCLUSIONS: ISC effectively neutralizes venous stasis during laparoscopic surgery and may decrease the risk of post-operative thromboembolic complication. Therefore, it is recommended for all prolonged laparoscopic procedures.