Seyit Hakan, Dolğun İlke, Bayram Erkan, Şener Fevkiye Nur, Çiçek Müslüm
Department of General Surgery, Faculty of Medicine, Istınye University Medicalpark Gaziosmanpasa Hospital, Istanbul, Turkey.
Clinic of Anesthesiology and Reanimation, Haseki Training and Research Hospital, Istanbul, Turkey.
Surg Endosc. 2025 Mar;39(3):1829-1838. doi: 10.1007/s00464-025-11538-2. Epub 2025 Jan 21.
The aim of our study is to compare the effect of the 30° reverse Trendelenburg position combined with the beach chair position on respiratory parameters in laparoscopic sleeve gastrectomy (LSG) with the 30° reverse Trendelenburg position alone.
Fifty patients with body mass index > 30 were included in the study. The patients were divided into two groups; in the control group, the standard 30° reverse Trendelenburg. In the beach chair group, the feet were positioned at 30° flexion from the hips after a 30° RTP. For both positions, blood pressures, pulses, saturations, EtCO2, respiratory rate, inspiratory pressure (Pins), positive end-expiratory pressure (PEEP), minute volume, tidal volume, peak airway pressure (Ppeak), and dynamic compliance were recorded. In addition, the general surgeon was asked about his satisfaction with the intra-abdominal operation site view and whether he was uncomfortable with the position.
Regardless of the group, the average age of the cases was 36.7 ± 12.1 years. There was no difference between the groups in terms of age, gender, BMI, operation time, blood pressures, heart rates, EtCO2, respiratory rate, PEEP, minute volume, tidal volume, and postoperative oxygen saturation (p > 0.05). Inspiratory and peak pressure were lower and dynamic compliance was higher in the beach chair position (p < 0.05). It was observed that the beach chair position decreased inspiratory and peak pressures and increased dynamic compliances in patients with a BMI between 35.1 and 40 (p < 0.05). Surgical satisfaction was high for both positions and there was no discomfort with the position.
It was determined that the beach chair position in LSGs reduced inspiratory and peak pressures and increased dynamic compliance. These parameters were related to BMI, and the beach chair position was more positive in terms of intraoperative lung pressures and dynamic compliance, especially in patients with a BMI between 35.1 and 40.
gov ID: NCT06402474.
我们研究的目的是比较30°头低脚高位联合沙滩椅位对腹腔镜袖状胃切除术（LSG）患者呼吸参数的影响与单纯30°头低脚高位的影响。
纳入50例体重指数>30的患者。患者分为两组；对照组采用标准30°头低脚高位。沙滩椅组在30°头低脚高位后，双脚从髋部屈曲30°。对于两种体位，记录血压、脉搏、饱和度、呼气末二氧化碳分压（EtCO2）、呼吸频率、吸气压力（Pins）、呼气末正压（PEEP）、分钟通气量、潮气量、气道峰压（Ppeak）和动态顺应性。此外，询问普外科医生对腹腔内手术视野的满意度以及他对该体位是否感到不适。
无论组别如何，病例的平均年龄为36.7±12.1岁。两组在年龄、性别、体重指数、手术时间、血压、心率、EtCO2、呼吸频率、PEEP、分钟通气量、潮气量和术后氧饱和度方面无差异（p>0.05）。沙滩椅位的吸气和峰压较低，动态顺应性较高（p<0.05）。观察到沙滩椅位可降低体重指数在35.1至40之间患者的吸气和峰压，并增加动态顺应性（p<0.05）。两种体位的手术满意度均较高，且该体位无不适感。
确定在LSG中沙滩椅位可降低吸气和峰压并增加动态顺应性。这些参数与体重指数有关，沙滩椅位在术中肺压力和动态顺应性方面更具优势，尤其是对于体重指数在35.1至40之间的患者。
美国国立医学图书馆临床试验注册中心标识符：NCT06402474
