INTERMITTENT SEQUENTIAL COMPRESSION OF THE LOWER-LIMBS PREVENTS VENOUS STASIS IN LAPAROSCOPIC AND CONVENTIONAL COLORECTAL SURGERY

PURPOSE: This study was designed to evaluate the influence of intraope rative intermittent sequential compression (ISC) on venous blood retur n from the lower limbs during laparoscopic and conventional colorectal colectomy. METHODS: Fifty patients undergoing laparoscopic (n = 25) o r conventional (n = 25) cotorectal surgery were included in a prospect ive study. Peak venous flow (PFV) and the cross-sectional are a (CSA) of the femoral vein were assessed by Doppler ultrasound examination in traoperatively. RESULTS: age, gender, and body mass Index were compara ble between both groups. Baseline PFV was 21 +/- 6.6 cm/s in the conve ntional and 18.4 +/- 6.4 cm/s in the laparoscopic group (P = 0.2), ISC increased PFV to 156 +/- 29 percent of the baseline value in the conv entional group and to 161 +/- 29 percent in the laparoscopic group. PF V decreased after abdominal insufflation to 127 +/- 19 percent of the baseline value in the laparoscopic group and after laparotomy to 134 /- 27 percent in tile conventional group (P = 0.3). PFV decreased slig htly in both groups during surgery but remained well above the baselin e value, Baseline CSA was 1.02 +/- 0.17 cm(2) in the conventional grou p and 1 +/- 0.23 cm(2) in the laparoscopic group. ISC decreased CSA to 0.91 +/- 0.18 cm(2) (conventional) and 0.85 +/- 0.18 cm(2) (laparosco pic) after initiation of ISC. CSA was 0.92 +/- 0.18 cm(2) after abdomi nal iasufflat ion in the laparoscopic group, and it was 0.93 +/- 0.18 cm(2) after laparotomy in the conventional group (P = 0.4). During sur gery, there were no differences in absolute CSA or CSA changes compare d with the baseline value in bath groups. Postoperative circumference of tile calf and thigh were not different between both groups. Postope rative thromboembolic complications did not occur. CONCLUSION: ISC eff ectively increases venous blood flow from the lower limbs during conve ntional and laparoscopic colorectal resections and may decrease the ri sk of postoperative deep vein thrombosis, Therefore, ISC is strongly r ecommended in every prolonged laparoscopic procedure.