Respiratory function is impaired less by transverse than by median vertical supraumbilical incisions

Respiratory function in the first four days after elective cholecystectomy has been compared in 15 women in whom abdominal incision was transverse and 15 in whom it was median vertical. Ventilatory function (vital capacity and forced expiratory volume in one second) and blood gas tensions (partial pressures of oxygen and of carbon dioxide in arterial blood, arterial whole-blood carbon dioxide, and alveolo-arterial oxygen tension difference) were determined on the day before operation and on the first, second and fourth postoperative days. Ventilatory function was depressed postoperatively in all the patients, but the depression was significantly less, and of significantly shorter duration, after the transverse than after the median vertical approach. Significant changes in blood gas tensions were noted postoperatively after both incisions, but without significant difference between the two groups.