Key result
Midline incision in markedly obese patients caused a greater increase in postoperative alveolar-arterial oxygen tension difference compared to transverse incision.
Why the study?
Does a midline incision compared to a transverse incision worsen postoperative alveolar-arterial oxygen tension difference in markedly obese patients undergoing jejunoileal bypass?
Observational (n=48)
Does a midline incision compared to a transverse incision worsen postoperative alveolar-arterial oxygen tension difference in markedly obese patients undergoing jejunoileal bypass?
In markedly obese patients undergoing jejunoileal bypass, a midline incision results in a more profound and prolonged reduction in arterial oxygenation postoperatively compared to a transverse incision.
Answers are grounded in this paper and cite their sources.
May worsen postoperative oxygenation with midline versus transverse incision in obese patients; leaves open optimal approach pending randomized trials.
Forty-eight markedly obese patients for elective jejunoileal bypass were studied during spontaneous ventilation preoperatively and then postoperatively after 2 to 4 hours and on each of days 1 to 5 to determine the effect of the operative incision (midline versus transverse) on the alveolar-arterial oxygen tension difference (A-aDO2). Compared with control (Pre-op.) A-aDO2, there was a significant increase in A-aDO2 in all patients, beginning in the postanesthetic recovery area and continuing through postoperative (P.O.) day 4. Comparing the mean increase in A-aDO2 (P.O.-Pre-op.) between the two incision groups, patients with a midline incision had a significantly greater (p smaller than 0.001) increase in A-aDO2 on control (Pre-op.) value by day 5. The authors conclude that in markedly obese subjects, the midline incision can be expected to result in both more profound and more prolonged reduction in arterial oxygenation postoperatively.
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Vaughan et al. (1975) conducted an observational in Markedly obese patients for elective jejunoileal bypass (n=48). Midline incision vs. Transverse incision was evaluated on Alveolar-arterial oxygen tension difference (A-aDO2) (p=<0.001). Midline incision in markedly obese patients caused a greater increase in postoperative alveolar-arterial oxygen tension difference compared to transverse incision.
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