Systematic Reviews
Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Dec 14, 2014; 20(46): 17603-17617
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17603
Table 1 Description of the baseline characteristics for the articles selected from the first literature search
Ref.Baseline characteristics
Frazee et al[17]Comparative measurements of FVC, FEV1 and FEF25%-75% variables preoperatively and on the 1st postoperative day after LC and OC
Hall et al[18]Comparison of the incidence of postoperative pulmonary complications (collapse/consolidation, unexplained temperature > 38  °C and positive sputum microbiology) after LC and OC
Coskun et al[19]Comparative measurements of the FVC, FEV1, Tiffeneau index, PEF and MEF25% variables before and 24 h after LC and OC
Damiani et al[20]Comparative meta-analytic study focusing on the evaluation of the Tiffenneau index after LC and OC
Osman et al[21]Comparative measurements for FVC, FEV1, Tiffenneau index and ABGs variables preoperatively and on the first day after LC and OC
Putensen-Himmer et al[22]Comparative measurements for FVC, FEV1, FRC and ABGs variables preoperatively and up to the 3rd postoperative day after LC and OC
Mealy et al[23]Comparative measurements for FVC, FEV1, PF, ABGs, urinary cortisol, vanillylmandelic acid, metanephrines and nitrogen loss, CRP, ESR and pain analogue scale preoperatively and up to 48 h after LC and OC
Williams et al[24]Comparative measurements for FVC, FEV1 and Maximum Forced Expiratory Flow Rate preoperatively and after LC and OC, according to patient’s cooperation
Gunnarsson et al[25]Comparative measurements for FVC, FEV1 and ABGs variables before surgery and 2 h and the first day after LC and OC
Karayiannakis et al[26]Comparative measurements for FVC, FEV1, FRC, FEF25%-75% and ABGs variables preoperatively and on the second day after LC and OC
Hendolin et al[27]Comparative measurements for FVC, FEV1, Peak Flow Velocity and arterial oxygen tension variables and measurements for plasma concentrations of catecholamines, cortisol and glucose preoperatively, in the recovery room and on the first day after LC and OC
Hasukić et al[28]Comparative measurements for FVC, FEV1, FEF25%-75%, Peak Expiratory Flow and ABGs variables preoperatively and on the first day after LC and OC
Bablekos et al[29]Comparative measurements of lung volumes (FVC, VC , ERV, IC, FRC, RV/TLC variables), flow rates (FEV1, Tiffenneau index, PEF, FEF25%-75% variables) and ABGs parameters preoperatively, on the 2nd and on the 8th day after LC and OC
Ravimohan et al[30]Comparative measurements for FVC, FEV1, FEF25%-75%, PEF, Tiffenneau index and ABGs parameters preoperatively, on the first and on the sixth postoperative day after LC and OC
Bablekos et al[31]Comparative measurements of Control of Breathing indices (VT, BF, TI, TI/TTOT, Po.1, Zminsp) and airway resistance (Raw) preoperatively, two days and eight days after LC and OC
McMahon et al[32]Minute ventilation, arterial carbon dioxide tension, end-tidal CO2 tension, peak airway pressure and arterial oxygen levels were studied just before operation and at the time of gallbladder removal during LC and OC
Mimica et al[36]Examination of the influence of physical therapy on both the values of respiratory parameters, such as FVC, FEV1, Tiffenneau index, and ABGs variables preoperatively and to the sixth day after LC and OC
Farrow et al[37]The authors showed that LC is associated with significantly less morbidity compared with OC. Variables such as FVC and FEV1 along with the occurrence of postoperative pulmonary complications and narcotic doses were studied preoperatively to the third day after LC and OC
Redmond et al[38]Parameters determining the immune function such as monocyte superoxide anion (O2-) and tumor necrosis factor release, neutrophil O2- levels and chemotaxis, serum cortisol and CRP were studied prior to surgery and on the first and third days after LC and OC
Kimberley et al[39]FVC, FEV1, Maximum voluntary HGS and MIP were studied preoperatively and on the first day after LC and OC
FVC: Forced vital capacity (L); VC: Vital capacity (L); ERV: Expiratory reserve volume (L); IC: Inspiratory capacity (L); FRC: Functional residual capacity (L); FEV1: Forced expiratory volume in one second (L); FEF25%-75%: Maximal-mid expiratory flow rate (L/s); PEF: Peak expiratory Flow (L/s); MEF25%: Maximal expiratory flow in the first 25% of the FVC (L/s); Tiffenneau index: FEV1/FVC (%) ratio; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; ABGs: Arterial blood gases; VT: Tidal volume (L); BF: Breathing frequency (breaths per minute: bpm); TI : Inspiratory time (s); TI/TTOT: Duty cycle; Po.1 : Central respiratory drive (cmH2O); Zminsp: Mean Inspiratory Impedance (cmH2O/L.s); Raw: Airway resistance (cmH2O. L-1.s); LC: Laparoscopic cholecystectomy; OC: Open cholecystectomy; HGS: Handgrip strength; MIP: Maximal inspiratory pressure.
Table 2 Description of the baseline characteristics for the articles selected from the second literature search
Ref.Baseline characteristics
Johnson et al[44]Preoperative and postoperative measurements 24 h after LC of VC, FRC, arterial PO2 and chest-X-ray atelectasis.
Poulin et al[45]Postoperative values of FVC and FEV1 variables measured on the first day after LC compared with values of the respective pulmonary function indices recorded on the first day after upper abdominal surgery and cholecystectomy.
Schulze et al[43]Assessments of pain scores, peak flow values and subjective feeling of fatigue preoperatively, 6 h postoperatively and daily during the first week after operation for patients having undergone LC
Schauer et al[40]Comparative measurements for FVC, FEV1, FEF25%-75%, Tiffenneau Index, FEFMAX, total lung capacity and oxygen saturation preoperatively to ten days after surgery between LC and OC
Saunders et al[41]Measurements of FVC and the potential emergence of respiratory and gastrointestinal disturbances preoperatively to the first postoperative day between LC and OC
Torrington et al[42]Comparative evaluations for FVC and FEV1 and arterial blood gases between LC and OC preoperatively and 24 h after surgery
Chumillas et al[34]Comparative examination for FVC, FEV1 and arterial oxygenation values between LC and OC, from preoperatively up to 48 h after surgery
Hasukić et al[46]Comparative measurements for FVC, FEV1, FEF25%-75% and arterial oxygenation preoperatively and 24 h after LC (included in the statistical analysis)
VC: Vital capacity (L); FRC: Functional residual capacity (L); FVC: Forced vital capacity (L); FEV1: Forced expiratory volume in one second (L); FEF25%-75%: Maximal-mid expiratory flow rate (L/s); FEFMAX: Maximal forced expiratory flow (L/s); LC: Laparoscopic cholecystectomy; OC: Open cholecystectomy.
Table 3 Description of the baseline characteristics for the six additional articles used in the writing of this review
Ref.Baseline characteristics
Chuter et al[50]Parameters of respiratory pattern such as minute ventilation, tidal volume, the contribution of chest wall (VC/VT) to tidal volume and the contribution of the abdominal wall (Vab/VT) to tidal volume were studied preoperatively, on the first and on the third day after OC
Rademaker et al[47]FVC, FEV1 and PEF were examined in a half sitting position preoperatively, and 24 h postoperatively in patients having undergone elective LC and OC while the effects of thoracic epidural analgesia after LC were also studied
McMahon et al[51]FVC, FEV1, PEF, postoperative pain scores, analgesic consumption and oxygen saturation were examined preoperatively, on the first postoperative day and on the second postoperative day between patients who underwent LC and OC. The OC was performed with minilaparotomy surgical approach
Freeman and Armstrong[48]Measurements of FVC, FEV1, Tiffenneau index, FRC, TLC, inspiratory and expiratory mouth pressures were examined preoperatively, and 24 h postoperatively between LC and OC
Rovina et al[49]Measurements of FVC, FEV1, Tiffenneau index, blood gases indices, maximum static inspiratory (PImax) and maximum expiratory (PEmax) muscle pressures were studied preoperatively, on the first postoperative day and on the second postoperative day between LC and OC
Mimica et al[33]Spirometric parameters (FVC, FVE1, Tiffenneau index), arterial blood gases, abdominal circumference, intestinal peristalsis and defecation were studied preoperatively, to the sixth postoperative day between LC and OC
FVC: Forced vital capacity (L); FEV1: Forced expiratory volume in one second (L); FRC: Functional residual capacity (L); TLC: Total lung capacity (L); Tiffenneau index: FEV1/FVC(%) ratio; PImax: Maximum static inspiratory muscle pressure (cmH2O); PEmax: Maximum static expiratory muscle pressure (cmH2O); PEF: Peak expiratory flow.
Table 4 Median percentage and interquartile range of preoperative values in forced vital capacity, forced expiratory volume in one second, and Maximal-mid expiratory flow rate variables 24 h1 after laparoscopic and open cholecystectomies
VariablesStudies (n)% of preoperative value [Median (IQR)]
P value
LCOC
FVC (L)2177.6 (73.0, 80.0)55.4 (50.0, 64.0)< 0.001
FEV1 (L)1976.0 (72.3, 81.0)52.5 (50.0, 56.7)< 0.001
FEF25%-75% (L/s)878.8 (68.8, 80.9)60.0 (36.1, 66.1)0.005
1One study reported values at 8 h and four studies reported values at 48 h after operation. FVC: Forced vital capacity (L); FEV1: Forced expiratory volume in one second (L); FEF25%-75%: Maximal-mid expiratory flow rate (L/s).
Table 5 Forced vital capacity (L) sensitivity results
StudySMD95%CIWeight
LC
Putensen-Himmer et al[22]-0.937-1.866-(-0.009)3.0%
Gunnarsson et al[25]-0.803-1.392-(-0.214)7.4%
1Karayiannakis et al[26]-0.697-1.138-(-0.257)13.1%
Hendolin et al[27]-0.920-1.504-(-0.336)7.5%
Hasukić et al[28]-0.649-1.169-(-0.130)9.5%
Mimica et al[33]-1.197-1.624-(-0.771)14.1%
Freeman et al[48]-0.752-1.364-(-0.139)6.8%
1Bablekos et al[29]-0.905-1.593-(-0.218)5.4%
Mimica et al[36]-1.197-1.624-(-0.771)14.1%
Hasukić et al[46]-0.649-1.169-(-0.130)9.5%
Rademaker et al[47]-1.198-2.158-(-0.238)2.8%
1Rovina et al[49]-1.320-1.922-(-0.718)7.1%
Sub-total
I-V pooled SMD-0.933-1.093-(-0.773)100.0%
D + L pooled SMD-0.933-1.093-(-0.773)
OC
Putensen-Himmer et al[22]-1.637-2.664-(-0.610)5.0%
Gunnarsson et al[25]-2.785-3.932-(-1.637)4.0%
Hendolin et al[27]-1.970-2.695-(-1.244)9.9%
Hasukić et al[28]-1.656-2.266-(-1.046)14.0%
Mimica et al[33]-1.973-2.452-(-1.493)22.7%
1Bablekos et al[29]-1.000-1.935-(-0.065)6.0%
Mimica et al[36]-1.596-2.048-(-1.145)25.6%
Kimberley et al[39]-3.373-6.206-(-0.540)0.7%
1Rovina et al[49]-1.748-2.403-(-1.092)12.2%
Sub-total
I-V pooled SMD-1.771-1.999-(-1.542)100.0%
D + L pooled SMD-1.773-2.014-(-1.531)
Overall
I-V pooled SMD-1.208-1.339-(-1.077)
D + L pooled SMD-1.245-1.468-(-1.022)
Test(s) of heterogeneity
Heterogeneity statisticDegrees of freedomP valueI2
LC8.75110.6450.0%
OC8.5980.3796.8%
Overall52.0120< 0.00161.5%
148 h. LC: Laparoscopic cholecystectomy; OC: Open cholecystectomy; SMD: Standardized mean difference.
Table 6 Forced expiratory volume in one second (L/s) sensitivity results
StudySMD95%CIWeight
LC
Putensen-Himmer et al[22]-0.796-1.710-(0.118)3.1%
Mealy et al[23]-1.090-2.036-(-0.143)2.9%
1Karayiannakis et al[26]-0.706-1.147-(-0.265)13.4%
Hendolin et al[27]-0.920-1.504-(-0.336)7.6%
Hasukić et al[28]-1.000-1.538-(-0.462)9.0%
Mimica et al[33]-1.463-1.906-(-1.021)13.3%
Freeman et al[48]-0.913-1.535-(-0.290)6.7%
1Bablekos et al[29]-1.045-1.744-(-0.346)5.3%
Mimica et al[36]-1.463-1.906-(-1.021)13.3%
Hasukić et al[46]-1.000-1.538-(-0.462)9.0%
Kimberley et al[39]-1.167-1.725-(-0.608)8.3%
1Rovina et al[49]-0.794-1.360-(-0.229)8.1%
Sub-total
I-V pooled SMD-1.068-1.229-(-0.907)100.0%
D + L pooled SMD-1.068-1.229-(-0.907)
OC
Putensen-Himmer et al[22]-1.540-2.550-(-0.529)5.0%
1Karayiannakis et al[26]-1.756-2.273-(-1.238)19.2%
Hendolin et al[27]-1.980-2.707-(-1.253)9.7%
Hasukić et al[28]-2.078-2.732-(-1.424)12.0%
Mimica et al[33]-2.500-3.026-(-1.974)18.6%
1Bablekos et al[29]-1.286-2.257-(-0.314)5.4%
Mimica et al[36]-2.500-3.026-(-1.974)18.6%
Kimberley et al[39]-5.099-8.978-(-1.220)0.3%
1Rovina et al[49]-1.964-2.644-(-1.285)11.1%
Sub-total
I-V pooled SMD-2.091-2.318-(-1.865)100.0%
D + L pooled SMD-2.059-2.359-(-1.760)
Overall
I-V pooled SMD-1.412-1.543-(-1.280)
D + L pooled SMD-1.422-1.688-(-1.156)
Test(s) of heterogeneity
Heterogeneity statisticDegrees of freedomP valueI2
LC10.70110.4680.0%
OC12.5880.12736.4%
Overall75.3120< 0.00173.4%
148 h. LC: Laparoscopic cholecystectomy; OC: Open cholecystectomy; SMD: Standardized mean difference.