WANG HAO, GU KE, RAO LI-HUA, et al. Effects of different CO2 pneumoperitoneum pressures on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position. [J]. Journal of regional anatomy and operative surgery, 2025, 34(2): 150-153.
DOI:
WANG HAO, GU KE, RAO LI-HUA, et al. Effects of different CO2 pneumoperitoneum pressures on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position. [J]. Journal of regional anatomy and operative surgery, 2025, 34(2): 150-153. DOI: 10.11659/jjssx.04E024121.
Effects of different CO2 pneumoperitoneum pressures on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position
pneumoperitoneum pressures during surgery on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position.
Methods
2
A total of 88 overweight or obese patients who underwent laparoscopic panhysterectomy were selected and randomly divided into the low-pressure group and the high-pressure group according to random number table method,with 44 patients in each group. All patients used CO
2
as the pneumoperitoneum medium during surgery,with 10 mmHg of CO
2
pneumoperitoneum pressure in the low-pressure group and 15 mmHg of CO
2
pneumoperitoneum pressure in the high-pressure group. The operation-related indexes,respiratory indicators,nasopharyngeal temperature and adverse reactions of patients were compared between the two groups.
Results
2
There was no significant difference in the surgical time,blood loss,intraoperative infusion volume,incidence of organ injury,and laparotomy rate between the two groups (
P
>
0.05). The recovery time of anesthesia of patients in the low-pressure group was shorter than that in the high-pressure group (
P
<
0.05).At 30 minutes after the establishment of pn
eumoperitoneum,the peak airway pressure (Ppeak) and plateau pressure (Pplat) of patients in the high-pressure group were significantly higher than those in the low-pressure group (
P
<
0.05),while the dynamic lung compliance (Cdyn) of patients in the high-pressure group was significantly lower than that in the low-pressure group (
P
<
0.05).At 60 minutes after the establishment of pneumoperitoneum and the end of pneumoperitoneum, the nasopharyngeal temperature of patients in the high-pressure group were significantly lower than those in the low-pressure group (
P
<
0.05). The incidences of intraoperative hypothermia and shivering in the high-pressure group were significantly higher than those in the low-pressure group (
P
<
0.05).
Conclusion
2
Compared with 15 mmHg of CO
2
pneumoperitoneum pressure,10 mmHg of CO
2
pneumoperitoneum pressure on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position does not increase surgical difficulty,and the patients has lower airway pressure,better lung compliance,fewer adverse reactions,and faster recovery,which can also avoid intraoperative hypothermia.
关键词
CO2气腹超重肥胖腹腔镜全子宫切除低体温Trendelenburg体位
Keywords
CO2 pneumoperitoneumoverweightobesitylaparoscopepanhysterectomyhypothermiaTrendelenburg position
references
Ma SJ,Xi B,Yang L,et al. Trends in the prevalence of overweight,obesity,and abdominal obesity among Chinese adults between 1993 and 2015[J].Int J Obes (Lond),2021,45(2): 427-437.doi:10.1038/s41366-020-00698-xhttp://dx.doi.org/10.1038/s41366-020-00698-x.
Hedenstierna G,Tokics L,Reinius H,et al. Higher age and obesity limit atelectasis formation during anaesthesia: an analysis of computed tomographydata in 243 subjects[J]. Br J Anaesth,2020,124(3):336-344.doi:10.1016/j.bja.2019.11.026http://dx.doi.org/10.1016/j.bja.2019.11.026.
Emile SH,Elgamal M,Elshobaky A,et al.Identifying patients at high risk of having pulmonary dysfunction before laparoscopic bariatric surgery and its impact on postoperative pulmonary complications[J].J Laparoendosc Adv Surg Tech A,2019,29(11):1456-1461.doi:10.1089/lap.2019.0459http://dx.doi.org/10.1089/lap.2019.0459.
Safety and effectiveness analysis of laparoscopic radical resection of colorectal cancer without indwelling gastric tube
Effects of different sevoflurane elution methods on awakening quality and cognitive function of elderly obese patients undergoing hip joint replacement
Effect of intravenous infusion of low-dose remifentanil on obese scarred uterine puerperae undergoing cesarean section under epidural anesthesia
Application of the Glisson hepatic pedicle priority approach marked by APR triangle in laparoscopic anatomic right hemihepatectomy
Effects of different CO2 pneumoperitoneum pressures on delirium and cognitive function after laparoscopic radical resection of rectal cancer in the elderly
Related Author
HU Yu-fei
LI Heng
OUYANG Jun-feng
FU Yan
CHEN Tie-sheng
TIAN Zhen
HAO Hong-qi
ZHONG Hua-juan
Related Institution
Department of General Surgical,Taihe Hospital of Shiyan City in Hubei Province/Affiliated Hospital of Hubei University of Medicine
Department of Anesthesiology, Suqian Hospital of Nanjing Drum-Tower Hospital Group /Affiliated Suqian Hospital of Xuzhou Medical University, Suqain Jiangsu
Department of Anesthesiology, Yancheng Third People's Hospital
Department of Breast Surgery,Tangshan People's Hospital
Endoscopy Room,Affiliated Hospital of Tangshan Vocational and Technical College