ABSTRACT
ADVANTAGES Postoperative pain and suppression of pulmonary function are well-known sequelae of abdominal surgery. While physician bias and patient expectations make a truly objective assessment of pain difficult, multiple prospective, randomized trials have found a reduction in narcotic requirements in patients undergoing laparoscopic colectomy.(5, 6, 8) In the COST trial, patients who underwent successful laparoscopic resections had decreased use of both oral and intravenous analgesics.(1)
In an attempt to document improved pulmonary function in patients undergoing laparoscopic surgery for colon cancer at
the Cleveland Clinic, preoperative and postoperative spirometry was performed every 12 hours postoperatively in 55 patients randomized to the laparoscopic surgery group and 54 patients in the open surgery group.(5) These measurements consisted of an 80% recovery of baseline forced vital capacity and forced expiratory volume in-second from each patient. The median recovery for the laparoscopic group was 3 days vs. 6 days in the conventional group. Schwenk et al. had similar results in a similarly designed trial.(8) These results suggest a reduction in postoperative pain and quicker recovery of pulmonary function in patients undergoing laparoscopic colectomy.
