Intermittent sequential compression of the lower limbs prevents venous stasis in laparoscopic and conventional colorectal surgery

PURPOSE: This study was designed to evaluate the influence of intraoperative intermittent sequential compression (ISC) on venous blood return from the lower limbs during laparoscopic and conventional colorectal colectomy. METHODS: Fifty patients undergoing laparoscopic (n = 25) or conventional (n = 25) cotorectal surgery were included in a prospective study. Peak venous flow (PFV) and the cross-sectional are a (CSA) of the femoral vein were assessed by Doppler ultrasound examination intraoperatively. RESULTS: age, gender, and body mass Index were comparable between both groups. Baseline PFV was 21 +/- 6.6 cm/s in the conventional and 18.4 +/- 6.4 cm/s in the laparoscopic group (P = 0.2), ISC increased PFV to 156 +/- 29 percent of the baseline value in the conventional group and to 161 +/- 29 percent in the laparoscopic group. PFV decreased after abdominal insufflation to 127 +/- 19 percent of the baseline value in the laparoscopic group and after laparotomy to 134 +/- 27 percent in the conventional group (P = 0.3). PFV decreased slightly in both groups during surgery but remained well above the baseline value, Baseline CSA was 1.02 +/- 0.17 cm(2) in the conventional group and 1 +/- 0.23 cm(2) in the laparoscopic group. ISC decreased CSA to 0.91 +/- 0.18 cm(2) (conventional) and 0.85 +/- 0.18 cm(2) (laparoscopic) after initiation of ISC. CSA was 0.92 +/- 0.18 cm(2) after abdominal iasufflat ion in the laparoscopic group, and it was 0.93 +/- 0.18 cm(2) after laparotomy in the conventional group (P = 0.4). During surgery, there were no differences in absolute CSA or CSA changes compared with the baseline value in bath groups. Postoperative circumference of the calf and thigh were not different between both groups. Postoperative thromboembolic complications did not occur. CONCLUSION: ISC effectively increases venous blood flow from the lower limbs during conventional and laparoscopic colorectal resections and may decrease the risk of postoperative deep vein thrombosis, Therefore, ISC is strongly recommended in every prolonged laparoscopic procedure.