Effect of laparoscopic radical gastrectomy assisted by sustained inflation on surgical efficacy and risk
Objective To observe the impact of laparoscopic radical gastrectomy assisted by sustained inflation(SI)on surgical efficacy and postoperative risk.Methods One hundred and twelve patients with gastric cancer admitted to First Hospital,Nanyang Medical College from January 2021 to December 2022 were selected for the randomized controlled trial.The enrolled patients were divided into an observation group and a control group by the random number table method,with 56 cases in each group.There were 30 males and 26 females in the observation group;they were(60.35±5.22)years old.There were 33 males and 23 females in the control group;they were(61.23±5.16)years old.All the patients took laparoscopic radical gastrectomy.The control group took routine anesthesia and mechanical ventilation;in addition,the observation group were assisted by SI.The perioperative hemodynamics,respiratory mechanics,oxygenation function,and the incidences of pulmonary complications(PPC)72 h after the surgery were compared between the two groups.x2 and t were used.Results There were no statistical differences in hemodynamics,respiratory mechanics,and oxygenation function indicators between the two groups before the establishment of pneumoperitoneum(T0)(all P＞0.05).The heart rates(HR)and mean arterial pressures(MAP)10(T1)and 30 min(T2)after the establishment of pneumoperitoneum in the observation group were(80.52±10.41)times/min,(115.75±20.61)mmHg(1 mmHg=0.133 kPa),(82.44±10.36)times/min,and(118.45±20.61)mmHg,which were lower than those in the control group[(85.25±10.36)times/min,(130.46±20.17)mmHg,(89.25±10.32)times/min,and(141.44± 20.61)mmHg],with statistical differences(t=2.410,3.817,3.485,and 5.903;all P＜0.05).The differences of alveoli-arterial oxygen pressure(A-aDO2)and respiratory index(RI)at T1 and T2 in the observation group were(125.77±20.61)mmHg,(35.77±5.28),(165.33±30.61)mmHg,and(40.12± 10.36),which were lower than those in the control group[(140.33±20.45)mmHg,(38.46±5.61),(192.25±30.72)mmHg,and(47.62±10.35)],with statistical differences(t=3.753,2.613,4.645,and 3.833;all P＜0.05).The peak airway pressures(Ppeak)and mean airway pressures(Pmean)at T1 and T2 in the observation group were(18.44±5.16)mmHg,(6.62±1.77)mmHg,(25.61±5.32)mmHg,and(7.69±2.45)mmHg,which were lower than those in the control group[(21.33±5.62)mmHg,(7.82± 2.31)mmHg,(28.45±5.66)mmHg,and(8.95±2.21)mmHg],with statistical differences(t=2.835,3.086,2.736,and 2.858;all P＜0.05).Within 72 h after the surgery,the incidence of PPC in the observation group was lower than that in the control group[10.71％(6/56)vs.23.21％(13/56)],with a statistical difference(x2=5.547,P＜0.05).Conclusion Radical gastrectomy assisted by SI for patients with gastric cancer can effectively maintain the stability of perioperative hemodynamics,respiratory mechanics,and oxygenation function,and is also of great significance in reducing the risk of postoperative PPC.
Radical gastrectomy for gastric cancerLaparoscopySustained inflationRespiratory mechanicsPulmonary complications
万方数据
维普
