الفهرس 
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Abstract
Obese patients show altered respiratory mechanics making them more liable to postoperative pulmonary complications. Thus, the management of oxygenation and prevention of postoperative complications especially atelectasis in morbidly obese patients undergoing laparoscopic procedures presents many challenging aspects to the anesthetist. Although numerous studies conducted in the past years, there is no superior guideline that indicates the best ventilation mode during laparoscopic anesthesia in morbid obese patients.
The aim of this study was to compare volume controlled ventilation and pressure controlled ventilation in the prevention of postoperative atelectasis (detected by lung ultrasonography) in morbidly obese patients undergoing laparoscopic gastric sleeve operation.
This reandomized prospective study was conducted on 52 patients undergoing laparoscopic gastric sleeve surgery in Ain Shams University Hospitals. Patients were randomized into two groups. In group (V): 26 patients were ventilated intra operatively using volume controlled mode. In group (P): 26 patients were ventilated intraoperatively using pressure controlled mode.
The primary study outcome was the incidence of Postoperative pulmonary atelectasis detected by lung Ultrasonography. Comparisons were also done between both groups as regards demographic data, duration of surgery, PaO2, SaO2, PaCO2 (mean intraoperative values then 30 minutes, 12 and 24 hours postoperative)
The results of this study revealed no significant differences between PCV and VCV as regards the incidence of postoperative lung atelectasis immediately postoperative (69.2% with VCV vs 61.5% with PCV, P=0.368), 12 hours postoperative (61.5% with VCV vs 53.8% with PCV, P=0.282) and 24 hours postoperative (53.8% with VCV vs 46.2% with PCV, P=0.325). There were also no significant differences between VCV and PCV as regards baseline, intra- and post-operative PaCO2 levels as well as baseline and postoperative SaO2 and PaO2 values. However, PCV showed better intraoperative oxygenation compared to VCV. SaO2 was 96.32 %±1.85 and 97.25 % ±1.37 in VCV and PCV groups respectively (P=0.027) while PaO2 was 212.75 mmHg ±20.13 and 225.8 mmHg ±18.69 in VCV and PCV groups respectively (P =0.011)