Search

Background: This study was designed to determine the impact of the degree of obesity on respiratory mechanics and simple hemodynamic parameters at laparoscopic bariatric surgery., Methods: The patients were divided into two groups, each of which included 24 patients (a morbidly obese group and a super obese group) undergoing laparoscopic bariatric surgery. Dynamic respiratory compliance, respiratory resistance, and peak inspiratory pressures were measured at four time points: 10 min after anesthesia induction (T1: induction), 10 min after pneumoperitoneum (T2: pneumoperitoneum), 10 min after terminating pneumoperitoneum (T3: end-pneumoperitoneum), and before extubation (T4: extubation). The systolic, diastolic, and mean arterial pressures and the heart rate values were measured noninvasively in T0 (10 min before operation)., Results: Obesity was found to cause a statistically significant increase in respiratory resistance and a peak inspiratory pressure and a decrease in dynamic respiratory compliance. In the morbidly obese group, the lowest dynamic respiratory compliance was 37 ± 12 mL/cm H(2)O, but it was 33 ± 13 mL/cm H(2)O in the super obese group. The systolic pressure, diastolic pressure, and mean arterial pressure were found to decrease significantly in both groups., Conclusions: Morbid obesity and super obesity have negative effects on hemodynamics and respiratory mechanics.

Background: The aim of this study is to identify the effectiveness of perioperative pneumoperitoneum to prevent air leak after the lobectomy-bilobectomy operations for lung cancer., Methods: A prospective study was designed on consecutive 50 patients who had lobectomy-bilobectomy operations for lung cancer and whose remnant lung had failed to fill the half of the hemithoracic cavity under 30 cm H(2)O positive pressure ventilation during the operation with totally relaxed diaphragm. The patients were divided into two groups: group 1 (25 patients) with perioperative pneumoperitoneum, group 2 (25 patients) without perioperative pneumoperitoneum., Results: The statistical analysis between the two groups did not show any significant difference in terms of age, preoperative FEV1, and the type of resection. Perioperative pneumoperitoneum significantly reduced the duration of postoperative air leak (2.2 +/- 1.15 days vs. 6.04 +/- 3.27 days p < 0.0001) and total chest tube drainage time (3.84 +/- 0.98 days vs. 7.88 +/- 3.16 days p < 0.001)., Conclusion: Perioperative pneumoperitoneum after lobectomy-bilobectomy operations for lung cancer is an effective method to decrease air leak and chest tube drainage time.