Low pneumoperitoneum pressure facilitates postoperative pain relief and gastrointestinal function recovery in laparoscopic gastrointestinal surgery: a systematic review and meta-analysis
ObjectiveThe potential benefits of low pneumoperitoneum pressure (LPP) in laparoscopic gastrointestinal surgery, particularly gastric procedures, remain insufficiently investigated. This meta-analysis aims to systematically evaluate the advantages of LPP in laparoscopic gastrointestinal surgery comp...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1665112/full |
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| author | Kai Lu Xuefeng Peng Ke Lan Faqiang Zhang Yong Cheng Hua Yang |
| author_facet | Kai Lu Xuefeng Peng Ke Lan Faqiang Zhang Yong Cheng Hua Yang |
| author_sort | Kai Lu |
| collection | DOAJ |
| description | ObjectiveThe potential benefits of low pneumoperitoneum pressure (LPP) in laparoscopic gastrointestinal surgery, particularly gastric procedures, remain insufficiently investigated. This meta-analysis aims to systematically evaluate the advantages of LPP in laparoscopic gastrointestinal surgery compared to standard pneumoperitoneum pressure (SPP).MethodsA comprehensive literature search was conducted in Embase, Web of Science, PubMed, and Cochrane Library databases from inception to April 10, 2025. Studies comparing LPP with SPP in laparoscopic gastrointestinal surgery, including both randomized controlled trials (RCTs) and observational studies, were systematically reviewed. Data were analyzed using RevMan 5.3 software, with primary outcomes including postoperative pain at rest, pain in post-anesthesia care unit (PACU), and activity-related pain.ResultsTwelve studies were included in the meta-analysis. Compared with SPP, LPP significantly reduced postoperative pain at rest (SMD = -0.40, 95% CI: -0.68 to -0.12, P = 0.005) and pain in PACU (SMD = -1.06, 95% CI: -1.65 to -0.47, P = 0.0004). Additionally, LPP was associated with faster recovery of gastrointestinal function (SMD = -0.27, 95% CI: -0.50 to -0.05, P = 0.02). However, no significant differences were observed between the two groups in terms of activity-related pain, operative time, intraoperative blood loss, surgical field visibility, length of hospital stay, anastomotic leakage, or postoperative complications. Notably, LPP was more frequently associated with intraoperative adjustments to pneumoperitoneum pressure (OR = 4.01, 95% CI: 2.48 to 6.50, P < 0.00001).ConclusionsIn laparoscopic gastrointestinal surgery, LPP provides clinically relevant benefits by reducing postoperative pain at rest and in PACU, as well as accelerating gastrointestinal recovery. However, surgeons should be aware of the potential need for more frequent intraoperative adjustments to pneumoperitoneum pressure when using LPP.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/search, identifier CRD420251037390. |
| format | Article |
| id | doaj-art-d0018c75dfea4adda3a814ba33606ea4 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-d0018c75dfea4adda3a814ba33606ea42025-08-21T04:10:35ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16651121665112Low pneumoperitoneum pressure facilitates postoperative pain relief and gastrointestinal function recovery in laparoscopic gastrointestinal surgery: a systematic review and meta-analysisKai Lu0Xuefeng Peng1Ke Lan2Faqiang Zhang3Yong Cheng4Hua Yang5Department of General Surgery, Zigong Fourth People’s Hospital, Zigong, Sichuan, ChinaDepartment of General Surgery, Zigong Fourth People’s Hospital, Zigong, Sichuan, ChinaDepartment of General Surgery, Zigong Fourth People’s Hospital, Zigong, Sichuan, ChinaDepartment of General Surgery, Zigong Fourth People’s Hospital, Zigong, Sichuan, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of General Surgery, Zigong Fourth People’s Hospital, Zigong, Sichuan, ChinaObjectiveThe potential benefits of low pneumoperitoneum pressure (LPP) in laparoscopic gastrointestinal surgery, particularly gastric procedures, remain insufficiently investigated. This meta-analysis aims to systematically evaluate the advantages of LPP in laparoscopic gastrointestinal surgery compared to standard pneumoperitoneum pressure (SPP).MethodsA comprehensive literature search was conducted in Embase, Web of Science, PubMed, and Cochrane Library databases from inception to April 10, 2025. Studies comparing LPP with SPP in laparoscopic gastrointestinal surgery, including both randomized controlled trials (RCTs) and observational studies, were systematically reviewed. Data were analyzed using RevMan 5.3 software, with primary outcomes including postoperative pain at rest, pain in post-anesthesia care unit (PACU), and activity-related pain.ResultsTwelve studies were included in the meta-analysis. Compared with SPP, LPP significantly reduced postoperative pain at rest (SMD = -0.40, 95% CI: -0.68 to -0.12, P = 0.005) and pain in PACU (SMD = -1.06, 95% CI: -1.65 to -0.47, P = 0.0004). Additionally, LPP was associated with faster recovery of gastrointestinal function (SMD = -0.27, 95% CI: -0.50 to -0.05, P = 0.02). However, no significant differences were observed between the two groups in terms of activity-related pain, operative time, intraoperative blood loss, surgical field visibility, length of hospital stay, anastomotic leakage, or postoperative complications. Notably, LPP was more frequently associated with intraoperative adjustments to pneumoperitoneum pressure (OR = 4.01, 95% CI: 2.48 to 6.50, P < 0.00001).ConclusionsIn laparoscopic gastrointestinal surgery, LPP provides clinically relevant benefits by reducing postoperative pain at rest and in PACU, as well as accelerating gastrointestinal recovery. However, surgeons should be aware of the potential need for more frequent intraoperative adjustments to pneumoperitoneum pressure when using LPP.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/search, identifier CRD420251037390.https://www.frontiersin.org/articles/10.3389/fonc.2025.1665112/fullpneumoperitoneum pressurepostoperative painlaparoscopic gastrointestinal surgerygastrointestinal diseaseLPP |
| spellingShingle | Kai Lu Xuefeng Peng Ke Lan Faqiang Zhang Yong Cheng Hua Yang Low pneumoperitoneum pressure facilitates postoperative pain relief and gastrointestinal function recovery in laparoscopic gastrointestinal surgery: a systematic review and meta-analysis Frontiers in Oncology pneumoperitoneum pressure postoperative pain laparoscopic gastrointestinal surgery gastrointestinal disease LPP |
| title | Low pneumoperitoneum pressure facilitates postoperative pain relief and gastrointestinal function recovery in laparoscopic gastrointestinal surgery: a systematic review and meta-analysis |
| title_full | Low pneumoperitoneum pressure facilitates postoperative pain relief and gastrointestinal function recovery in laparoscopic gastrointestinal surgery: a systematic review and meta-analysis |
| title_fullStr | Low pneumoperitoneum pressure facilitates postoperative pain relief and gastrointestinal function recovery in laparoscopic gastrointestinal surgery: a systematic review and meta-analysis |
| title_full_unstemmed | Low pneumoperitoneum pressure facilitates postoperative pain relief and gastrointestinal function recovery in laparoscopic gastrointestinal surgery: a systematic review and meta-analysis |
| title_short | Low pneumoperitoneum pressure facilitates postoperative pain relief and gastrointestinal function recovery in laparoscopic gastrointestinal surgery: a systematic review and meta-analysis |
| title_sort | low pneumoperitoneum pressure facilitates postoperative pain relief and gastrointestinal function recovery in laparoscopic gastrointestinal surgery a systematic review and meta analysis |
| topic | pneumoperitoneum pressure postoperative pain laparoscopic gastrointestinal surgery gastrointestinal disease LPP |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1665112/full |
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