Universität zu Köln

Abdelsamad, Ahmed ORCID: 0000-0002-5451-4504, Ruehe, Lars, Lerch, Lutz Peter, Ibrahim, Ehab, Daenenfaust, Lars and Langenbach, Mike Ralf (2022). Active aspiration versus simple compression to remove residual gas from the abdominal cavity after laparoscopic cholecystectomy: a randomized clinical trial. Langenbecks Arch. Surg., 407 (5). S. 1797 - 1805. NEW YORK: SPRINGER. ISSN 1435-2451

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Abstract

Purpose After laparoscopic surgical procedures, residual gas in the abdominal cavity can cause post-operative pain, which is commonly located in the shoulder region. Previous studies suggested that post-laparoscopy pain can be prevented by active suctioning of intraabdominal gas at the end of surgery. Methods This randomized controlled trial (registered at DRKS 00,023,286) compared active suctioning versus manual compression in their ability to reduce pain after laparoscopic cholecystectomy. Patients scheduled for laparoscopic cholecystectomy were eligible for trial participation. The primary outcome measure was post-operative pain intensity after 12 h. All the patients were examined by MRI scanning to quantify the intraabdominal gas volume after the intervention. Results As planned, 60 patients were recruited. The two groups (n = 30 each) were very similar at the end of surgery. Active suctioning reduced the amount of residual pneumoperitoneum more than simple compression (median volume 1.5 versus 3.0 ml, p = 0.002). The primary outcome measure, abdominal pain after 12 h, was slightly lower in the intervention group (- 0.5 points, 95% confidence interval + 0.5 to - 1.7), but without reaching statistical significance (p = 0.37). After 12 h, shoulder pain was present in 10 patients in each group (p = 1.0). Independent of group assignment, however, residual gas volume was significantly associated with higher pain intensity. Conclusions Active suctioning appears to have only a minor preventive effect on post-laparoscopy pain, probably because evacuation of the pneumoperitoneum remains incomplete in some patients. Other more effective maneuvers for gas removal should be preferred.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Abdelsamad, Ahmed UNSPECIFIED orcid.org/0000-0002-5451-4504 UNSPECIFIED Ruehe, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Lerch, Lutz Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Ibrahim, Ehab UNSPECIFIED UNSPECIFIED UNSPECIFIED Daenenfaust, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Langenbach, Mike Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-669271
DOI:	10.1007/s00423-022-02522-8
Journal or Publication Title:	Langenbecks Arch. Surg.
Volume:	407
Number:	5
Page Range:	S. 1797 - 1805
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1435-2451
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSTLAPAROSCOPIC SHOULDER PAIN; POSTOPERATIVE PAIN; PNEUMOPERITONEUM; ASSOCIATION; EVACUATION; INTENSITY; DRAINAGE; SURGERY Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66927