Aim: This study is aimed to evaluate the incidence of the postoperative deep vein thrombosis (DVT) and the cell damage from compartment iatrogenic syndrome, analyzing two groups of patients operated laparoscopically, one of which assisted with a Sequential Compression Device (SCD).
Material of study: A patients' series submitted to laparoscopic surgery over a period at least 90 minutes. The venous flow in the lower limbs was detected with the Echo Colour Doppler method, and only one of the two groups was assisted with the SCD.
Results: Between November 2006 and October 2007, 35 patients were evaluated, 21 of them wew assisted with SDC and the remaining 14 patients were the control group. All patients had a follow-up was extended for 5 years at the interval of 7 days, 14 days, 30 days, 3 and 5 years.
Discussion: The results were confirmed that the application of SCD is able to neutralize the negative effect of the PNP reducing the possible risk of thromboembolic venous stasis and the improvement of lactic acid and of myoglobinemia are attributable to a reduction of preload. With the use of IPC, it decreases venous stasis, improves venous return and cardiac output increases, preventing cell damage by hypoperfusion.
Conclusions: The use of a SCD applied to the lower limbs allows an increase in venous return from the lower limbs so reducing the risk of DVT.
Key words: Cellular damage, DVT, Pneumoperitoneum.
In chirurgia laparoscopica l’induzione del pneumoperitoneo (PNP) realizza una sindrome compartimentale iatrogena con ripercussioni sul circolo venoso profondo degli arti inferiori. In questo studio abbiamo voluto valutare l’incidenza di Trombosi Venosa Profonda (TVP) postoperatoria e del danno cellulare da sindrome compartimentale iatrogena analizzando due gruppi di pazienti, ad uno dei quali è stato applicato un dispositivo Sequential Compression Device (SCD). I pazienti selezionati sono stati suddivisi in due gruppi e sono stati sottoposti a chirurgia laparoscopica con durata non inferiore a 90’. È stato rilevato con metodo ECOCOLOR-DOPPLER il flusso venoso degli arti inferiori e soltanto ad uno dei due gruppi è stato applicato un dispositivo SCD. Da novembre 2006 a ottobre 2007 sono stati valutati 35 pz, 21 pz con dispositivo SCD e 14 pz utilizzati come gruppo controllo, con follow-up a 7 gg, 14 gg, 30 gg, a 3 e 5 anni. L’utilizzo di un dispositivo SCD applicato agli arti inferiori consente un aumento del ritorno venoso dagli arti inferiori diminuendone il rischio di TVP.