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01.12.2014 | Original Article | Ausgabe 12/2014

Journal of Gastrointestinal Surgery 12/2014

A Prospective Clinical Study Evaluating the Development of Bowel Wall Edema During Laparoscopic and Open Visceral Surgery

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 12/2014
Autoren:
Goran Marjanovic, Jasmina Kuvendziska, Philipp Anton Holzner, Torben Glatz, Olivia Sick, Gabriel Seifert, Birte Kulemann, Simon Küsters, Jodok Fink, Sylvia Timme, Ulrich Theodor Hopt, Ulrich Wellner, Tobias Keck, Wojciech Konrad Karcz
Wichtige Hinweise
Part of the following work was presented at the German Visceral Medicine Association Meeting (Viszeralmedizin 2013) in September 2013 in Nuernberg as a 5-minute oral presentation.

Abstract

Background

To examine bowel wall edema development in laparoscopic and open major visceral surgery.

Methods

In a prospective study, 47 consecutively operated patients with gastric and pancreatic resections were included. Twenty-seven patients were operated in a conventional open procedure (open group) and 20 in a laparoscopic fashion (lap group). In all procedures, a small jejunal segment was resected during standard preparation, of which we measured the dry-wet ratio. Furthermore, HE staining was performed for measuring of bowel wall thickness and edema assessment.

Results

Mean value (±std) of dry-wet ratio was significantly lower in the open than in the lap group (0.169 ± 0.017 versus 0.179 ± 0.015; p = 0.03) with the same amount of fluid administration in both groups and a longer infusion interval during laparoscopic surgery. Subgroup analyses (only pancreatic resections) still showed similar results. Histologic examination depicted a significantly larger bowel wall thickness in the open group.

Conclusions

Laparoscopic surgery does not seem to lead to the bowel wall edema observed to occur in open surgery regardless of the degree of intravenous fluid administration, thus supporting its use even in major visceral surgery.

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