Key result
Preoperative incentive spirometry in major abdominal surgery is linked to an 18% pulmonary complication rate.
Why the study?
Preoperative incentive spirometry is widely used to improve respiratory performance, but its effect on postoperative pulmonary complication incidence in Indian tertiary-care settings is less well characterised.
Does preoperative incentive spirometry training improve respiratory recovery and affect postoperative pulmonary complications in patients undergoing elective major abdominal surgery?
Observational (n=100)
No
Does preoperative incentive spirometry training improve respiratory recovery and affect postoperative pulmonary complications in patients undergoing elective major abdominal surgery?
Preoperative incentive spirometry training is associated with a favorable respiratory recovery trajectory, though open surgery, prolonged duration, smoking, and obesity remain key predictors of postoperative pulmonary complications.
Answers are grounded in this paper and cite their sources.
Despite training, PPCs persist especially after open surgery; leaves open efficacy versus no training in elective abdominal procedures.
Background: Postoperative pulmonary complications (PPCs) remain a common cause of morbidity after major abdominalsurgery. Preoperative incentive spirometry is widely used to improve respiratory performance, though its effect on PPCincidence in Indian tertiary-care settings is less well characterised. This study assessed the effect of preoperative incentivespirometry on PPCs and postoperative spirometric performance in patients undergoing elective major abdominal surgery.Materials and Methods: This prospective observational study enrolled 100 patients aged >16 years undergoing electivemajor abdominal surgery lasting >2 hours at a tertiary care hospital. Patients received standardised preoperative incentivespirometry training, with performance assessed preoperatively, on postoperative days 2 and 3, and at discharge. PPCincidence and its association with surgical and patient-related risk factors were analysed using Chi-square/Fisher's exacttests, with p<0.05 considered significant. Results: Mean age was 42.7 ± 17.6 years, with female predominance (67%); 58%underwent laparoscopic and 42% open surgery. Spirometry performance declined from 98% adequate preoperatively to 33%on POD 2 (mean volume 593 ± 314 mL, p<0.001), recovering to 96% by discharge. PPCs occurred in 18% of patients —atelectasis (12%), pneumonia (6%) — significantly more frequent after open (38.1%) than laparoscopic (3.4%) surgery(p<0.001). Age >60 years, BMI ≥30 kg/m², smoking, COPD, open surgery, and operative duration >3 hours weresignificantly associated with PPCs. Conclusion: Preoperative incentive spirometry training was associated with a favourablepostoperative respiratory recovery trajectory. Open surgery, prolonged operative duration, smoking, and obesity were keypredictors of PPCs, supporting targeted perioperative respiratory care in high-risk patients.
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Dungrani et al. (2026) conducted an observational in Elective major abdominal surgery (n=100). Preoperative incentive spirometry training was evaluated on Postoperative pulmonary complications (PPCs). Preoperative incentive spirometry in major abdominal surgery resulted in an 18% incidence of pulmonary complications, with higher rates in open vs laparoscopic surgery.
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