Shoulder pain after laparoscopic versus open hepatectomy:a prospective cohort study
Objective To compare postoperative shoulder pain between laparoscopy-assisted hepatectomy and open hepatectomy.Methods A total of 79 liver tumor patients who underwent laparoscopic liver resection at Fudan University Shanghai Cancer Center between June and September 2022 were selected(laparoscopy group).Concurrently,139 liver tumor patients who underwent open liver resection were chosen as controls(open group).Propensity score matching(PSM)was employed to achieve a 1∶1 match,resulting in 60 cases in each group after successful matching.The general characteristics(such as gender composition,age,BMI)and surgery-related data(the use of epidural anesthesia,the proportion of patients with tumor diameter＞5 cm,sufentanil dosage,the number of liver segments resected,and operative duration),as well as the incidences of postoperative shoulder pain and moderate to severe shoulder pain,were compared between the two groups.The degree of shoulder pain was assessed by using the numeric rating scale(NRS)on the day of surgery,and day 1 and 2 after surgery.Results There were no statistically significant differences between the two groups in terms of gender composition,age,BMI,sufentanil dosage,the number of liver segments resected,operative duration,the use of epidural anesthesia,or the proportion of patients with tumor diameter＞5 cm(all P＞0.05).The incidence of postoperative shoulder pain was 33.3％(20/60)in the open group and 41.7％(25/60)in the laparoscopy group,with no significant difference(P＞0.05).The incidences of moderate to severe postoperative shoulder pain were 16.7％(10/60)in the open group and 21.7％(13/60)in the laparoscopy group(P＞0.05).The NRS scores for shoulder pain were 2.0(1.0,5.0),2.5(0,4.0),and 0(0,1.0)on the day of surgery,and day 1 and 2 after surgery,respectively,in the open group.The NRS scores for shoulder pain were 3.0(0,6.0),2.0(0,3.5),and 0(0,3.0)on the day of surgery,and day 1 and 2 after surgery,respectively,in the laparoscopy group.There were no significant differences in the NRS score at any time points between the two groups(all P＞0.05).Conclusion Compared to open liver resection,laparoscopic liver resection does not increase the incidence of postoperative shoulder pain,nor does it exacerbate the severity of postoperative shoulder pain.
万方数据
维普
