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Comparison of VCV and PCV-VG modes on diaphragmatic function in diabetic patients undergoing laparoscopic colorectal surgery: a prospective randomized controlled study.

Yanan Wang·Linyao Chen·Zixuan Xu·Jianwen Ye·Kuan Lu·Jiehao Sun·Jiahao Zhou
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Abstract

BACKGROUND: Diabetic patients are prone to induce diaphragmatic weakness, which can lead to postoperative pulmonary complications (PPCs). The optimal mechanical ventilation mode may potentially improve postoperative diaphragmatic function. This study evaluates the effects of two ventilation modes under driving pressure-guided ventilation strategy on diaphragmatic function, as assessed by diaphragm thickening fraction (DTF) and diaphragm excursion (DE), in diabetic patients following laparoscopic colorectal surgery. METHODS: Eighty patients diagnosed with Type II diabetes scheduled for elective laparoscopic colorectal surgery, were randomly allocated to either the pressure-controlled volume-guaranteed ventilation (PCV-VG) group (Group P) or the volume-controlled ventilation (VCV) group (Group V) during surgery. The primary outcome was diaphragmatic function assessed during both tidal breathing and maximal inspiratory effort after surgery. Secondary outcomes included intraoperative mechanical power, PPCs, and other complications. RESULTS: A total of eighty patients were included in the final analysis. The averaged area under the curve (AUC) for mechanical power during ventilation was significantly lower in Group P than in Group V (p = 0.002). PCV-VG significantly improved both DE and DTF within the first two days post-surgery (AUCDEtidal: p = 0.088, AUCDTFtidal: p = 0.004, AUCDEmax: p = 0.029, AUCDTFmax: p = 0.017). Postoperative diaphragmatic weakness was less frequent in Group P than in Group V (p = 0.019). However, there was no difference in the incidence of PPCs between the two groups (p = 0.155). CONCLUSION: PCV-VG mode can reduce intraoperative mechanical power, better preserve postoperative diaphragmatic function. However, these improvements did not translate into clinical benefits, as evidenced by the lack of reduction in the incidence of PPCs.

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HumansFemaleLaparoscopyDiaphragmDiabetes Mellitus, Type 2MaleProspective StudiesMiddle AgedAgedPostoperative ComplicationsRespiration, ArtificialColorectal Surgical ProceduresDiabetesDiaphragmatic functionMechanical powerPCV-VGPostoperative pulmonary complicationsJournal ArticleRandomized Controlled TrialComparative StudyResearch Support, Non-U.S. Gov't

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Yanan Wang, Linyao Chen, Zixuan Xu, Jianwen Ye, Kuan Lu, Jiehao Sun, Jiahao Zhou. 2026-04-09. Comparison of VCV and PCV-VG modes on diaphragmatic function in diabetic patients undergoing laparoscopic colorectal surgery: a prospective randomized controlled study.. https://doi.org/10.1080/07853890.2026.2656512

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Journal Article; Randomized Controlled Trial; Comparative Study; Research Support, Non-U.S. Gov't resourceAged subjectColorectal Surgical Procedures subjectComparative Study subjectDiabetes subjectDiabetes Mellitus, Type 2 subjectDiaphragm subjectDiaphragmatic function subjectFemale subjectHumans subjectJournal Article subjectLaparoscopy subjectMale subjectMechanical power subjectMiddle Aged subjectPCV-VG subject

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