In laparoscopic cholecystectomy operations applied before and after pneumoperitonium recruitment maneuver the effect of postoperative atelektasia evaluation with lung ultrasonography

Purpose: In the study, the effect of laparoscopic cholecystectomy operations on atelectasis in the postoperative period of the recruitment maneuver applied at different times was evaluated by lung USG. Method: A total of 105 patients, aged 18-65 years, with ASA physical status I-Ⅱ who underwent elective laparoscopic cholecystectomy were included in the study. The patients included in the study were randomly evaluated in 3 groups: Group 1 was taken as the control group. Recruitment maneuver (RM) was applied to the patients in the other 2 groups. The patients in the second group (Group 2) were applied before RM pneumoperitoneum, and the patients in the third group (Group 3) were applied after RM pneumoperitoneum. Thus, it was evaluated as Group 1 (CONTROL), Group 2 (PRE-PP), Group 3 (POST-PP). Recruitment maneuver was performed automatically with 30% FiO2, 30 cmH2O pressure for 30 seconds in a mechanical ventilator. The demographic characteristics, vital signs, dynamic lung compliance values and lung USG scores of the patients were recorded, and the effect of the recruitment maneuver on these data was evaluated. Result: There was no significant difference between the demographic data and vital values of the patients (p>0.05). There was no significant difference between the groups in the values of dynamic lung compliance in the entry, intraoperative and pre-extubation periods (p>0.05). A significant difference was found between group 1 (CONTROL) time to decrease and increase in dynamic compliance values before entry and extubation of the patients in Group 3 (POST PP) within the group (p=0.001/p<0.001). When the postoperative lung ultrasonography scores of the patients were evaluated, a statistically significant difference was found between the groups in comparison time (p<0.001). Conclusion: In patients in group 1, an increase in lung USG scores was observed in the direction of supporting atelectasis.However, the dynamic compliance values of the patients in this group also decreased. In the patients in the second group, a decrease in postoperative lung USG scores and improvement in tissue aeration were detected, and dynamic compliance values were equal to the entry values. Patients in the third group showed a decrease in postoperative lung USG scores as a result of the regression of atelectasis, and dynamic compliance values were found to be higher than the entry values. Keywords: laparoscopic cholecystectomy, Recruitment maneuver, USG