TY - JOUR
T1 - Evaluation of Perioperative Lung Ultrasound Scores in Laparoscopic Living Donor Nephrectomy Surgeries
T2 - A Prospective Observational Trial
AU - Bingül, Emre S.
AU - Canbaz, Mert
AU - Tefik, Tzevat
AU - Oktar, Mevlüt Tayfun
AU - Savran Karadeniz, Meltem
N1 - Publisher Copyright:
© 2025 Elsevier Inc.
PY - 2025/7/1
Y1 - 2025/7/1
N2 - Background: Laparoscopic upper abdominal surgeries are prone to respiratory complications, possibly due to mechanical ventilation and the surgery itself. In this study, we aimed to investigate the changes in lung condition in living donor nephrectomy patients using perioperative ultrasound guidance. Methods: Living donor nephrectomy patients who underwent fully laparoscopic surgery in the lateral position were included in the study. The lung ultrasound score (LUS) was evaluated after intubation (T1LUS), before extubation (T2LUS), and 30 minutes after extubation (T3LUS). The primary outcome was the comparison of T1LUS and T2LUS to observe the effect of the intraoperative period on lung condition. Secondarily, T3LUS also was evaluated for any residual change remaining during the acute postoperative period. In addition, the occurrence of postoperative pulmonary complications (PPCs) and changes in oxygenation were investigated. Results: A total of 30 patients were enrolled in the study. T2LUS and T3LUS were significantly higher than T1LUS (18 [17-20.3] and 11 [10-14.3] vs 7 [5-9.3]; P < .001). Only 4 patients (13%) experienced mild pulmonary complications in the first 24 hours postoperation. Patients with PPCs demonstrated higher T2LUS and T3LUS compared to patients without PPCs (21 [21-22.5] vs 18 [16.8-20] and 16 [14.5-18.3] vs 10.5 [9.8-14], respectively; P < .05), yet arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (FiO2) ratios did not differ between patients with PPCs and patients without PPCs, indicating adequate oxygenation for all participants. Conclusion: According to the ultrasonographic examination, the intraoperative period causes some degree of deterioration in lung condition in laparoscopic living donor nephrectomy patients. Despite the finding that patients developing PPCs tended to exhibit higher LUS, their oxygenation levels remained sufficient throughout the operative period.
AB - Background: Laparoscopic upper abdominal surgeries are prone to respiratory complications, possibly due to mechanical ventilation and the surgery itself. In this study, we aimed to investigate the changes in lung condition in living donor nephrectomy patients using perioperative ultrasound guidance. Methods: Living donor nephrectomy patients who underwent fully laparoscopic surgery in the lateral position were included in the study. The lung ultrasound score (LUS) was evaluated after intubation (T1LUS), before extubation (T2LUS), and 30 minutes after extubation (T3LUS). The primary outcome was the comparison of T1LUS and T2LUS to observe the effect of the intraoperative period on lung condition. Secondarily, T3LUS also was evaluated for any residual change remaining during the acute postoperative period. In addition, the occurrence of postoperative pulmonary complications (PPCs) and changes in oxygenation were investigated. Results: A total of 30 patients were enrolled in the study. T2LUS and T3LUS were significantly higher than T1LUS (18 [17-20.3] and 11 [10-14.3] vs 7 [5-9.3]; P < .001). Only 4 patients (13%) experienced mild pulmonary complications in the first 24 hours postoperation. Patients with PPCs demonstrated higher T2LUS and T3LUS compared to patients without PPCs (21 [21-22.5] vs 18 [16.8-20] and 16 [14.5-18.3] vs 10.5 [9.8-14], respectively; P < .05), yet arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (FiO2) ratios did not differ between patients with PPCs and patients without PPCs, indicating adequate oxygenation for all participants. Conclusion: According to the ultrasonographic examination, the intraoperative period causes some degree of deterioration in lung condition in laparoscopic living donor nephrectomy patients. Despite the finding that patients developing PPCs tended to exhibit higher LUS, their oxygenation levels remained sufficient throughout the operative period.
UR - https://www.scopus.com/pages/publications/105009253073
U2 - 10.1016/j.transproceed.2025.05.013
DO - 10.1016/j.transproceed.2025.05.013
M3 - Article
C2 - 40581564
AN - SCOPUS:105009253073
SN - 0041-1345
VL - 57
SP - 1025
EP - 1033
JO - Transplantation Proceedings
JF - Transplantation Proceedings
IS - 6
ER -