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Comparison of low and standard pneumoperitoneum pressure in laparoscopic pediatric inguinal hernia repair
1Department of General Surgery, Dongyang People's Hospital; Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
Insights
Low pneumoperitoneum pressure (LPP) in pediatric inguinal hernia repair reduces anesthesia and recovery times, with lower CO2 levels compared to standard pressure (SPP). Postoperative outcomes were similar, but long-term studies are needed.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Anesthesiology
Background:
- The optimal pneumoperitoneum pressure for laparoscopic pediatric inguinal hernia repair remains under investigation.
- Assessing the safety and effectiveness of low pneumoperitoneum pressure (LPP) is crucial.
Purpose of the Study:
- To compare the benefits of low pneumoperitoneum pressure (LPP) versus standard pneumoperitoneum pressure (SPP) in pediatric laparoscopic inguinal hernia repair.
Main Methods:
- Retrospective cohort analysis of 169 pediatric patients undergoing laparoscopic inguinal hernia repair.
- Patients were divided into LPP and SPP groups.
- Anesthesia and postoperative characteristics were analyzed.
Main Results:
- The LPP group demonstrated significantly shorter anesthesia and postanesthesia care unit (PACU) times (p=0.00, p=0.01).
- Lower end-tidal carbon dioxide (PETCO2) levels were observed in the LPP group.
- Reduced requirements for sufentanil citrate and midazolam were noted in the LPP group, with no significant difference in postoperative complications.
Conclusions:
- LPP is associated with reduced anesthesia and PACU times and lower PETCO2 compared to SPP.
- LPP offers comparable operation times and postoperative complication rates to SPP.
- Further long-term outcome studies are warranted to fully evaluate LPP in pediatric laparoscopic inguinal hernia repair.
Introduction:
The effectiveness and safety of low pneumoperitoneum in laparoscopic pediatric inguinal hernia repair is unclear and required to explore.
Aim:
To evaluate the benefits of low (LPP) vs. standard pneumoperitoneum pressure (SPP) in laparoscopic pediatric inguinal hernia repair.
Material And Methods:
We performed a retrospective cohort analysis of patients with pediatric inguinal hernia. The patients were divided into LPP and SPP groups. Anesthesia and postoperative characteristics were analyzed.
Results:
We enrolled 169 eligible patients in this study. Anesthesia and postanesthesia care unit times in the LPP group were lower than those in the SPP group (p = 0.00, p = 0.01, respectively). The LPP group had lower values for peak partial pressure of end-tidal carbon dioxide (PETCO2; mm Hg) (33.37 ±4.09 vs. 36.56 ±4.08), trough PETCO2 (38.33 ±5.04 vs. 40.46 ±4.14), and PETCO2 at the end of surgery (35.29 ±4.59 vs. 38.76 ±4.22). The LPP group required less sufentanil citrate (8.76 ±4.07 ml vs. 18.03 ±16.04 ml) and midazolam (1.56 ±0.45 ml vs 1.79 ±0.59 ml) vs. the SPP group, respectively. There was no significant difference between the groups regarding postoperative complications.
Conclusions:
LPP was associated with shorter anesthesia and postanesthesia care unit times, and lower PETCO2 values compared with SPP. Compared with the SPP group, the LPP group had comparable operation times and postoperative complications. However, long-term outcome studies are needed.
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