ISSN: 2451-0637
Archives of Medical Science - Civilization Diseases
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1/2021
vol. 6
 
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abstract:
Clinical research

The effect of active gas aspiration to reduce pain after laparoscopic sleeve gastrectomy for morbid obesity: a randomized controlled study

Hasan Erdem
1
,
Mehmet Gençtürk
1
,
Süleyman Çetinkünar
2
,
Abdullah Şişik
3
,
Selim Sözen
4

1.
Istanbul Obesity Surgery (IOC), Kurtköy Ersoy Hospital, Istanbul, Turkey
2.
Department of General Surgery, Adana City Training and Research Hospital, Adana, Turkey
3.
Department of General Surgery, University of Health Sciences, Ümraniye Education and Research Hospital, Istanbul, Turkey
4.
Sözen Surgery Clinic, Istanbul, Turkey
Arch Med Sci Civil Dis 2021; 6: e109–e116
Online publish date: 2021/09/20
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Introduction
Residual, intra-abdominal CO2 contributes to abdominal distension and pain after laparoscopic surgery. Our aim was to investigate the effects of active gas aspiration on postoperative outcomes and pain following laparoscopic sleeve gastrectomy.

Material and methods
Patients were randomly assigned to either the active gas reduction group (Group 1, n = 69) or the control group (Group 2, n = 74). After completion of the operative procedures, residual gas was aspirated with a flexible cannula in Group 1. In Group 2, gas release from the abdomen was performed using the port site by opening the gas tap only. The demographic data, body mass index, educational status, operation time, insufflated CO2 volume during the operation, and intraabdominal pressure were recorded. Postoperative pain assessment was performed using a numerical pain intensity scale (NPIS) at the 1st h, the 24th h, and the 3rd day.

Results
NPIS scores at the 24th h were significantly lower in Group 1 (p < 0.001). However, there were no significant differences in the NPIS scores following the 1st h and the 3rd day. No differences were found in the operation time (p > 0.05). According to the correlation analysis between the operation time and NPIS scores between the groups, in Group 1 the duration of surgery was significantly proportional to NPIS24. All patients were discharged from the hospital on the 4th postoperative day.

Conclusions
Active aspiration of the remaining gas just before the removal of the trocars is a simple procedure that reduces pain, leading to a more comfortable hospital stay.

keywords:

laparoscopic surgery, sleeve gastrectomy, postoperative pain

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