Chest
Volume 86, Issue 6, December 1984, Pages 891-895
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Clinical Investigations
Postoperative Chest Percussion with Postural Drainage in Obese Patients following Gastric Stapling

https://doi.org/10.1378/chest.86.6.891Get rights and content

Vigorous respiratory therapy can prevent the development of postoperative pulmonary complications which occur with increased frequency after upper abdominal surgery. Obesity poses an additional risk factor. To study the effects of postoperative chest percussion with postural drainage (CPT), 53 consecutive patients undergoing Roux-en-Y gastric stapling procedures for treatment of morbid obesity were randomized to two groups. Both received identical postoperative respiratory care, except the study group received additional CPT. It was concluded that the addition of CPT to patients without prior chronic lung disease undergoing upper abdominal surgery caused patient discomfort, increased hospital cost, and failed to affect the incidence of postoperative pulmonary complications.

Section snippets

Methods

Some 53 consecutive patients undergoing Roux-en-Y gastric bypass surgery for treatment of morbid obesity were randomized to the treatment and control groups. All patients were operated upon within a six-month period of time in 1982 by the same surgeon (DES), and received identical preoperative evaluations. Of the 53 patients, four dropped out of the study. Of the three treatment group patients who were deleted, two refused the postoperative therapy protocol, and one had surgery cancelled. One

Results

The CPT and no CPT (control) groups were compared by a variety of parameters. The mean age of the CPT patients was 39.9 years with a range of 15 to 57 years. In the control patients, the mean age was 37 years, and the age range 22 to 62 years. The sex distributions within the two groups showed 20 women and four men in the CPT group, and 21 women and four men in the control group. Comparison of additional parameters included cigarette smoking history, history of prior pulmonary diseases, dyspnea

Discussion

In this study, patients at high risk for postoperative pulmonary complications were randomly divided into two groups so that the value, if any, of postoperative chest physiotherapy could be assessed. All of these obese patients (125 percent to greater than 225 percent of ideal body weight) underwent Roux-en-Y gastric bypass surgery, with a number of additional upper abdominal procedures being performed. This patient group was chosen because of the well-accepted observation that upper abdominal

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