Influence of dynamic carbon dioxide pneumoperitoneum pressure on intraoperative hypothermia and postoperative recovery in patients undergoing laparoscopic radical resection for esophageal cancer
Objective To explore the influence of dynamic carbon dioxide pneumoperitoneum pressure on intraopera-tive hypothermia and postoperative recovery in patients undergoing laparoscopic radical resection for esophageal cancer.Method A total of 106 patients who underwent laparoscopic radical resection for esophageal cancer were divided into control group(n=58,carbon dioxide pneumoperitoneum pressure no change during surgery)and observation group(n=48,dynamic carbon dioxide pneumoperitoneum pressure during surgery)based on the different methods of carbon diox-ide pneumoperitoneum pressure during surgery.The hemodynamic indicators[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)],body temperature,lung function indicators[vital capacity,maximum ventilation volume(MW),forced expiratory volume in one second(FEV1)],inflammatory factors[interleukin-6(IL-6),procalcito-nin(PCT),C-reactive protein(CRP)],and recovery quality[40-item quality of recovery score(QoR-40)]were compared between the two groups.Result During the period of peripheral lymph node dissection and gastrointestinal reconstruc-tion,the SBP,DBP,and HR of the control group were higher than those during tumor resection,while the HR of the obser-vation group were higher than those during tumor resection,and the differences were statistically significant(P＜0.05).From the establishment of pneumoperitoneum to the end of surgery,the body temperature of the observation group were higher than those of the control group,the incidence of hypothermia during surgery in the observation group was 52.08％,which was lower than 72.41％of the control group,and the differences were statistically significant(P＜0.05).Three days after surgery,the vital capacity,MVV,FEV1,IL-6,PCT,and CRP levels of both groups were lower than those at one day before surgery,the vital capacity,MVV,FEV1 of observation group were higher than those of control group,the levels of IL-6,PCT,and CRP were lower than those of control group,and the differences were statistically significant(P＜0.05).Three days after surgery and at discharge,the QoR-40 scores of control group were lower than those of observation group and one day before surgery,the QoR-40 scores of the observation group first decreased and then increased,and the differ-ences were statistically significant(P＜0.05).Conclusion The dynamic carbon dioxide pneumoperitoneum pressure dur-ing laparoscopic radical resection for esophageal cancer is beneficial for maintaining stable hemodynamic,improving in-traoperative hypothermia,maintaining stable lung function indicators and inflammatory factor levels,and improving post-operative recovery quality.
万方数据
维普
