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Comparative study of different pneumoperitoneum modes on lower extremity deep venous blood flow velocity in patients undergoing laparoscopic surgery
Received date: 2022-05-20
Accepted date: 2022-08-31
Online published: 2022-09-28
Supported by
Project of Nursing Talent Team Construction of Shanghai Jiao Tong University School of Medicine(2021-21)
Objective ·To investigate the effects of stabilized pneumoperitoneum and traditional pneumoperitoneum on the blood flow velocity of the lower extremity deep veins in the patients undergoing laparoscopic surgery. Methods ·According to the convenience sampling method, a total of 60 patients undergoing laparoscopic abdominal and pelvic malignant tumor surgeries in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from April 2021 to September 2021 were selected, and the stabilized pneumoperitoneum group (n=30) and the traditional pneumoperitoneum group (n=30) were compared at T0 (before anesthesia), T1 (after anesthesia), T2 (after pneumoperitoneum stabilization), T3 (pneumoperitoneum at 60 min), T4 (pneumoperitoneum at 120 min), and T5 (after pneumoperitoneum) in blood flow velocity including peak systolic velocity (PSV) and end diastolic velocity (EDV). The activated partial thromboplastin time (APTT), prothrombin time (PT) and D‐dimer (D-D) were detected at 24 h before and after surgery. Results ·CO2 pneumoperitoneum slowed down the blood flow velocity of lower extremity deep veins. Repeated measurement ANOVA analysis showed the values of Ftime, Fgroupand Finteraction were 1 253.171, 4.905 and 13.338 (P<0.05), respectively for PSV, and 1 046.798, 21.163, and 11.090, respectively for EDV (P<0.01). There were great influences on PSV and EDV in the traditional pneumoperitoneum group. With the prolongation of pneumoperitoneum time, the difference of blood flow velocity in the stabilized pneumoperitoneum group was significantly lower than that in the traditional pneumoperitoneum group at T3, T4 and T5 time points (P<0.05). There were statistically significant differences in APTT, PT and D-D between the two groups at 24 h before and after surgery (P=0.000). There was no statistical difference in the incidence of deep vein thrombosis (DVT) between the two groups (χ2=0.215, P=1.000). Conclusion ·Stabilized pneumoperitoneum and traditional pneumoperitoneum have different effects on deep venous blood flow of lower extremities. It is recommended to use stabilized pneumoperitoneum to slow down the decrease of lower limb blood flow velocity for patients undergoing a long time laparoscopic surgery.
Huihua SUN , Qiuju TIAN , Beiwen WU . Comparative study of different pneumoperitoneum modes on lower extremity deep venous blood flow velocity in patients undergoing laparoscopic surgery[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022 , 42(9) : 1329 -1335 . DOI: 10.3969/j.issn.1674-8115.2022.09.021
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