Impact of lung ultrasound-guided recruitment on intraoperative pulmonary atelectasis during laparoscopic colectomy under general anesthesia

Context Atelectasis is a common and significant complication during general anesthesia, leading to impaired gas exchange and postoperative pulmonary complications (PPCs), particularly in laparoscopic surgeries requiring pneumoperitoneum and the Trendelenburg position. Aim This trial aims to compare the effectiveness of lung ultrasound-guided recruitment maneuvers (UG-RM) versus manual inflation recruitment maneuvers (MI-RM) in reducing intraoperative atelectasis during laparoscopic colectomy under general anesthesia. Patients and method The purpose of this randomized, double-blind trial was to evaluate how well lung UG-RM decreased intraoperative pulmonary atelectasis in comparison to manual inflation techniques. The manual inflating group and the ultrasound-guided lung recruitment group were randomly allocated to 60 patients having elective laparoscopic colectomy. To assess changes in lung aeration, lung ultrasonography scores were taken at four different times: T1: 5 min after induction, T2: 15 min after pneumoperitoneum, T3: 60 min after pneumoperitoneum, and T4: before extubation. Results The results demonstrated a significantly lower incidence of atelectasis in the UG-RM group compared with manual inflation recruitment maneuvers group at key time points during surgery ( P <0.05). The study also found that patients who received ultrasound-guided lung recruitment exhibited significantly lower postoperative lung ultrasound scores with a median of three (range: 2–4) compared with those in the manual inflation group, who had a median score of seven (range: 4–9), P less than 0.001. Furthermore, the ultrasound-guided group experienced a lower incidence of postoperative atelectasis (3.3%) than the manual inflation group (20%). Conclusion Lung ultrasound-guided recruitment was found more effective than manual inflation in reducing intraoperative pulmonary atelectasis during laparoscopic colectomy. The use of ultrasound guidance during lung recruitment may lead to improved lung aeration and better postoperative respiratory outcomes, suggesting its potential as a preferred technique in clinical practice.