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ORIGINAL PAPER
The impact of standard and low-pressure pneumoperitoneum on hydration in obese females undergoing laparoscopic cholecystectomy
 
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Submission date: 2017-07-30
 
 
Acceptance date: 2017-09-26
 
 
Publication date: 2018-03-30
 
 
Medical Studies 2018;34(1):1-8
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Disturbances in hydration status can increase the frequency of post-operative pain, nausea and vomiting (PONV), complicate the wound healing process and thus, increase the period of hospitalization, especially in overweight and obese patients.

Aim of the research:
To assess the impact of the standard and low-pressure pneumoperitoneum on hydration status of obese female patients undergoing laparoscopic cholecystectomy in the early post-operative period.

Material and methods:
The study included 52 female individuals with asymptomatic cholelithiasis who underwent laparoscopic cholecystectomy. Patients were assigned to three groups according to the body mass index and value of intra-abdominal pressure. Evaluation of the hydration status was performed at three time points: point 0 – before the operation, point 24 – 24 hour after the surgery, and point 48 – 48 hours after the surgery.

Results:
A higher total body water (TBW) and dehydration was observed in obese compared to normal weight patients in the time point 24 and 48. Extracellular water (ECW) was significantly higher in obese compared to normal weight patients in the time studied time point. Intracellular water (ICW) and ECW/ICW did not differ significantly between the studied groups in the studied time.

Conclusions:
Obesity alters the hydration status. Values of carbon-dioxide pneumoperitoneum pressure used during short duration laparoscopic surgery did not have an influence on the hydration status of the obese female patients.
REFERENCES (36)
1.
Formiguera X, Cantón A. Obesity: epidemiology and clinical aspects. Best Pract Res Clin Gastroenterol 2004; 18: 1125-1146.
 
2.
Arroyo-Johnson C, Mincey KD. Obesity Epidemiology World¬wide. Gastroenterol Clin North Am 2016; 45: 571-579.
 
3.
Zahorska-Markiewicz B, Mucha Z. Otyłość i leczenie operacyjne. Chirurgia Polska 2001; 3: 79-83.
 
4.
Sidhu RS, Raj PK, Treat RC, Scarcipino MA, Tarr SM. Obesity as a factor in laparoscopic cholecystectomy. Surg Endosc 2007; 21: 774-776.
 
5.
Litwin DE, Cahan MA. Laparoscopic cholecystectomy. Surg Clin North Am 2008; 88: 1295-1313.
 
6.
Brokelman WJ, Lensvelt M, Borel Rinkes IH, Klinkenbijl JH, Reijnen MM. Peritoneal changes due to laparoscopic surgery. Surg Endosc 2011; 25: 1-9.
 
7.
Nguyen NT, Wolfe BM. The physiologic effects of pneumoperitoneum in the morbidly obese. Ann Surg 2005; 241: 219-226.
 
8.
Mulier JP, Garcia M, Dillemans B. Pathophysiology of obesity. Impact on laparoscopy. Acta Anaesthesiol Belg 2009; 60: 149-153.
 
9.
Doubravska L, Dostalova K, Fritscherova S, Zapletalova J, Adamus M. Incidence of postoperative nausea and vomiting in patients at a University Hospital. Where are we today? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2010; 154: 69-76.
 
10.
Gan TJ, Soppitt A, Maroof M, el-Moalem H, Robertson KM, Moretti E, Dwane P, Glass PS. Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology 2002; 97: 820-826.
 
11.
Mythen MG, Webb AR. Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery. Arch Surg 1995; 130: 423-429.
 
12.
Das SK. Body composition measurement in severe obesity. Curr Opin Clin Nutr Metab Care 2005; 8: 602-606.
 
13.
Chumlea WC, Schubert CM, Sun SS, Demerath E, Towne B, Siervogel RM. A review of body water status and the effects of age and body fatness in children and adults. J Nutr Health Aging 2007; 11: 111-118.
 
14.
Vahidi H, Talebpour A, Tabatabaie O, Talebpour M. Changes in the body composition after laparoscopic gastric plication: a short-term prospective case series. Surg Obes Relat Dis 2016; 12: 577-581.
 
15.
Baker SP, Shock NW, Norris AH. Influence of age and obesity in women on basal oxygen consumption expressed in terms of total body water and intracellular water. In: Biological Aspects of Aging. Shock NW (ed.). Columbia University Press, New York 1962; 84-91.
 
16.
Steele JM, Bergery EY, Dunning MF, Brodie BB. Total body water in man. Am J Physiol 1950; 162: 313-317.
 
17.
Marken Lichtenbelt WD, Fogelholm M. Increased extracellular water compartment, relative to intracellular water compartment, after weight reduction. J Appl Physiol 1999; 87: 294-298.
 
18.
Lukaski HC. Methods for the assessment of human body composition: Traditional and new. Am J Clin Nutr 1987; 47: 537-556.
 
19.
Załuska W, Bednarek-Skublewska A, Szeliga-Król J, Załuska A, Książek A. Zastosowanie analizatora składu ciała ludzkiego do oceny nawodnienia u pacjentów leczonych metodą hemodializy z powodu schyłkowej niewydolności nerek. Nefrol Dializoter Pol 2010; 14: 195-196.
 
20.
Adanir T, Aksun M, Ozgürbüz U, Altin F, Sencan A. Does preoperative hydration affect postoperative nausea and vomiting? A randomized, controlled trial. J Laparoendosc Adv Surg Tech A 2008; 18: 1-4.
 
21.
Sartorio A, Malavolti M, Agosti F, Marinone PG, Caiti O, Battistini N, Bedogni G. Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis. Eur J Clin Nutr 2005; 59: 155-160.
 
22.
Resende CM, Camelo Júnior JS, Vieira MN, Ferriolli E, Pfrimer K, Perdoná GS, Monteiro JP. Body composition measures of obese adolescents by the deuterium oxide dilution method and by bioelectrical impedance. Braz J Med Biol Res 2011; 44: 1164-1170.
 
23.
Silva AM, Heymsfield SB, Gallagher D, Albu J, Pi-Sunyer XF, Pierson RN Jr, Wang J, Heshka S, Sardinha LB, Wang Z. Evaluation of between-methods agreement of extracellular water measurements in adults and children. Am J Clin Nutr 2008; 88: 315-323.
 
24.
Schoeller DA. Changes in total body water with age. Am J Clin Nutr 1989; 50: 1178-1181.
 
25.
Steen B. Body water in the elderly: A review. J Nutr Health Aging 1997; 1: 142-145.
 
26.
Lesser GT, Markofsky J. Body water compartments with human aging using fat-free mass as the reference standard. Am J Physiol 1979; 236: 215-220.
 
27.
Chumlea WC, Guo SS, Zeller CM, Reo NV, Siervogel RM. Total body water data for white adults 18 to 64 years of age: the Fels Longitudinal Study. Kidney Int 1999; 56: 244-252.
 
28.
Waki M, Kral JG, Mazariegos M, Wang J, Pierson RN Jr, Heymsfield SB. Relative expansion of extracellular fluid in obese vs. nonobese women. Am J Physiol 1991; 261: 199-203.
 
29.
Wang J, Pierson RN. Disparate hydration of adipose and lean tissue requires a new model for body water distribution in man. J Nutr 1976; 106: 1687-1693.
 
30.
Mazariegos M, Kral JG, Wang J, Waki M, Heymsfield SB, Pierson RN Jr., Thornton JC, Yasumura S. Body composition and surgical treatment of obesity. Effects of weight loss on fluid distribution. Ann Surg 1992; 216: 69-73.
 
31.
Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000; 85: 109-117.
 
32.
Holte K, Sharrock NE, Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth 2002; 89: 622-632.
 
33.
Ertel W, Oberholzer A, Platz A, Stocker R, Trentz O. Incidence and clinical pattern of the abdominal compartment syndrome after “damage-control” laparotomy in 311 patients with severe abdominal and/or pelvic trauma. Crit Care Med 2000; 28: 1747-1753.
 
34.
Balogh Z, McKinley BA, Cocanour CS, Kozar RA, Valdivia A, Sailors RM, Moore FA. Supranormal trauma resuscitation causes more cases of abdominal compartment syndrome. Arch Surg 2003; 138: 637-643.
 
35.
Mayberry JC, Welker KJ, Goldman RK, Mullins RJ. Mechanism of acute ascites formation after trauma resuscitation. Arch Surg 2003; 138: 773-776.
 
36.
Leone PA, Gallagher D, Wang J, Heymsfield SB. Relative overhydration of fat-free mass in postobese versus neverobese subjects. Ann N Y Acad Sci 2000; 904: 514-519.
 
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