Intermittent pneumatic sequential compression (ISC) of the lower extremities prevents venous stasis during laparoscopic cholecystectomy. A prospective randomized study

Surg Endosc. 1998 Jan;12(1):7-11. doi: 10.1007/s004649900583.

Abstract

Background: Fifty patients were included in a prospective randomized trial to evaluate the efficacy of intermittent sequential compression (ISC) of the lower extremities in preventing venous stasis during laparoscopic cholecystectomy.

Methods: We treated 25 patients with (+ISC) and 25 without (-ISC) intermittent sequential compression. Peak flow velocity (PFV) and cross-sectional area (CSA) of the right femoral vein were measured by Doppler ultrasound before, during, and after capnopneumoperitoneum with 14 mm Hg.

Results: PFV was 26.4 (8.4) cm/s and CSA was 1.03 (0.23) cm2 before pneumoperitoneum was induced. During abdominal insufflation, PFV decreased to 61% of the baseline value in the (-ISC) group but remained unchanged in the (+ISC) group (t = 5.17, df = 42.8, p < 0.01). CSA was 1.06 (0.22) cm2 before insufflation. It increased to 118% of the baseline in the (-ISC) group and to 108% in the (+ISC) group (t = -1.55, df = 47.1, p = 0.13). PFV and CSA returned to baseline values within 5 min after abdominal desufflation.

Conclusions: ISC effectively neutralizes venous stasis during laparoscopic surgery and may decrease the risk of post-operative thromboembolic complication. Therefore, it is recommended for all prolonged laparoscopic procedures.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bandages
  • Blood Flow Velocity
  • Cholecystectomy, Laparoscopic / methods*
  • Counterpulsation*
  • Evaluation Studies as Topic
  • Female
  • Hemodynamics*
  • Humans
  • Leg / blood supply
  • Male
  • Middle Aged
  • Prospective Studies
  • Regional Blood Flow
  • Thrombophlebitis / prevention & control*