SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1665112
This article is part of the Research TopicNational Colorectal Cancer Awareness Month 2025: Current Progress and Future Prospects on Colorectal Cancer Prevention, Diagnosis and TreatmentView all 11 articles
Low Pneumoperitoneum Pressure Facilitates Postoperative Pain Relief and Gastrointestinal Function Recovery in Laparoscopic Gastrointestinal Surgery: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Zigong Fourth People's Hospital, Zigong, China
- 2The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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The potential benefits of low pneumoperitoneum pressure (LPP) in laparoscopic gastrointestinal surgery, particularly gastric procedures, remain insufficiently investigated. This metaanalysis aims to systematically evaluate the advantages of LPP in laparoscopic gastrointestinal surgery compared to standard pneumoperitoneum pressure (SPP).A 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.Twelve 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).In 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.
Keywords: Pneumoperitoneum Pressure, Postoperative pain, laparoscopic gastrointestinal surgery, gastrointestinal disease, LPP
Received: 13 Jul 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Lu, Peng, Lan, Zhang, Cheng and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hua Yang, Zigong Fourth People's Hospital, Zigong, China
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