The study aimed to investigate the efficacy of PCV-VG combined with individual PEEP during laparoscopic surgery in the Trendelenburg position. 120 patients were randomly divided into four groups: VF group (VCV plus 5cmH₂O PEEP), PF group (PCV-VG plus 5cmH₂O PEEP), VI group (VCV plus individual PEEP), and PI group (PCV-VG plus individual PEEP). P_mean, P_peak, Cdyn, PaO₂/FiO₂, V_D/V_T, A-aDO₂ and Qs/Qt were recorded at T₁ (15 min after the induction of anesthesia), T₂ (60 min after pneumoperitoneum), and T₃ (5 min at the end of anesthesia). The CC16 and IL-6 were measured at T₁ and T₃. Our results showed that the P_mean was increased in VI and PI group, and the P_peak was lower in PI group at T₂. At T₂ and T₃, the Cdyn of PI group was higher than that in other groups, and PaO₂/FiO₂ was increased in PI group compared with VF and VI group. At T₂ and T₃, A-aDO₂ of PI and PF group was reduced than that in other groups. The Qs/Qt was decreased in PI group compared with VF and VI group at T₂ and T₃. At T₂, V_D/V_T in PI group was decreased than other groups. At T₃, the concentration of CC16 in PI group was lower compared with other groups, and IL-6 level of PI group was decreased than that in VF and VI group. In conclusion, the patients who underwent laparoscopic surgery, PCV-VG combined with individual PEEP produced favorable lung mechanics and oxygenation, and thus reducing inflammatory response and lung injury.Clinical Trial registry: chictr.org. identifier: ChiCTR-2100044928.

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