Effects of CO<sub>2</sub> Pneumoperitoneum and Posture on Circulation Function for Elderly Patients with Rectal Cancer During Laparoscopic Operation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YANGSun-hu ^1,2 , HOUJun-li ² , ABUDUSIMU ² ,  TABUSI Ahetibieke ² , ZHENGJian-zhong ² , MABo ² , RENFei ²

1. Department of General Surgery, No.3 People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201900, China;
2. Depar-tment of General Surgery, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, Xiniang Uygur Autonomous Region, China;

Corresponding?author：

TABUSI Ahetibieke, Email: ahet050@sina.com

Keywords：

Elderly patient; Rectal cancer; Laparoscopic operation; Circulation function

DOI：

10.7507/1007-9424.20150088

Video：

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Objective To explore the effects of CO₂ pneumoperitoneum and posture on circulation function for elderly patients with rectal cancer during laparoscopic operation. Methods Retrospective analysis of clinical data of 48 elderly patients with rectal cancer was performed, and the data included the heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), cardiac output (CO), cardiac index (CI), central venous pressure (CVP), pH, partial pressure of oxygen (PaO₂), and partial pressure of carbon dioxide (PaCO₂) at before anesthesia (T₁), after anesthesia (T₂), after the establishment of CO₂ pneumoperitoneum (T₃), placement in trendelenburg position after operation (T₄), 30 minutes after operation (T₅), 60 minutes after operation (T₆), 90 minutes after operation (T₇), and 120 minutes after operation (T₈). Results The levels of HR, SBP, DBP, MAP, CO, CI, pH, PaO₂, and PaCO₂ at 8 time points didn't statistically differed with each other (P>0.05), but the levels of CVP at T7 and T8 time point were significantly higher than those of T1 and T2 time point (P<0.05). Conclusions During laparoscopic operation period for the elderly patients with rectal cancer, the CVP will gradually increase. If the preoperative assessment and administration are done well during peri-operation period, laparoscopic operation is safe for the elderly patients with rectal cancer.

Citation： YANGSun-hu, HOUJun-li, ABUDUSIMU, TABUSI Ahetibieke, ZHENGJian-zhong, MABo, RENFei. Effects of CO₂ Pneumoperitoneum and Posture on Circulation Function for Elderly Patients with Rectal Cancer During Laparoscopic Operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(3): 331-334. doi: 10.7507/1007-9424.20150088 Copy

1.	?Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial):multicentre, randomised controlled trial. Lancet, 2005, 365(9472):1718-1726.
2.	Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer:short-term outcomes of a randomised trial. Lancet Oncol, 2005, 6(7):477-484.
3.	Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoseopically assisted and open colectomy for colon cancer. N Engl J Med, 2004, 350(20):2050-2059.
4.	Fleshman J, Sargent DJ, Green E, et al. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg, 2007, 246(4):655-662.
5.	Colon Cancer Laparoscopic or Open Resection Study Group; Buunen M, Veldkamp R, et al. Survival after laparoscopic surgery versus open surgery for colon cancer:long-term outcome of a randomised clinical trial. Lancet Oncol, 2009, 10(1):44-52.
6.	Jayne DG, Thorpe HC, Copeland J, et al. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg, 2010, 97(11):1638-1645.
7.	Roscio F, Bertoglio C, De Luca A, et al. Outcomes of laparoscopic surgery for colorectal cancer in elderly patients. JSLS, 2011, 15(3):315-321.
8.	王金保, 王姝媛, 王琪, 等. 不同氣腹壓條件下腹腔鏡膽囊摘除術患者血流動力學的變化. 臨床麻醉學雜志, 2012, 28(2):163-165.
9.	Jacobs M, Verdeja JC, Goldstein HS. Laparoscopic choledocholitho-tomy. J Laparoendosc Surg, 1991, 1(2):79-82.
10.	范瑩, 吳碩東, 于宏, 等. 腹腔鏡結直腸癌根治術與同期開腹手術對比的單中心回顧性研究. 中國普外基礎與臨床雜志, 2009, 16(5):384-388.
11.	梁耀澤, 余江, 張策, 等. 腹腔鏡與同期開腹直腸癌根治術后腫瘤學結果對比研究. 中國普外基礎與臨床雜志, 2010, 17(6):591-595.
12.	周海濤, 周志祥. 腹腔鏡手術或將成為高齡結直腸癌患者的常規外科治療方法. 中華腫瘤雜志, 2014, 36(1):2-4.
13.	卞正乾, 鐘鳴, 唐偉軍, 等. 80歲以上高齡結直腸癌患者接受腹腔鏡輔助根治手術的圍手術期安全性觀察. 腹腔鏡外科雜志, 2009, 14(1):41-44.
14.	孫建萍, 伍冀湘, 張京嵐. 開腹、氣腹腹腔鏡、無氣腹腹腔鏡結直腸癌手術對高齡患者術中心肺功能的影響. 中國微創外科雜志, 2010, 10(9):826-829.
15.	Kanwer DB, Kaman L, Nedounsejiane M, et al. Comparative study of low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy-a randomised controlled trial. Trop Gastroenterol, 2009, 30(3):171-174.
16.	Russo A, Marana E, Viviani D, et al. Diastolic function:the influence of pneumoperitoneum and Trendelenburg positioning during laparoscopic hysterectomy. Eur J Anaesthesiol, 2009, 26(11):923-927.
17.	Falabella A, Moore-Jeffries E, Sullivan MJ, et al. Cardiac function during steep Trendelenburg position and CO₂ pneumoperitoneum for robotic-assisted prostatectomy:a trans-oesophageal Doppler probe study. Int J Med Robot, 2007, 3(4):312-315.
18.	Alves A, Panis Y, Mathieu P, et al. Postoperative mortality and morbidity in French patients undergoing colorectal surgery:results of a prospective multicenter study. Arch Surg, 2005, 140(3):278-284.
19.	Alves A, Panis Y, Mantion G, et al. The AFC score:validation of a 4-item predicting score of postoperative mortality after colorectal resection for cancer or diverticulitis:results of a prospective multicenter study in 1 049 patients. Ann Surg, 2007, 246(1):91-96.
20.	Person B, Cera SM, Sands DR, et al. Do elderly patients benefit from laparoscopic colorectal surgery?. Surg Endos, 2008, 22(2):401-405.
21.	Latkauskas T, Rudinskaite G, Kurtinaitis J, et al. The impact of age on post-operative outcomes of colorectal cancer patients undergoing surgical treatment. BMC Cancer, 2005, 5:153.
22.	Grailey K, Markar SR, Karthikesalingam A, et al. Laparoscopic versus open colorectal resection in the elderly population. Surg Endosc, 2013, 27(1):19-30.
23.	梁輝, 管蔚, 陳國玉. 不同年齡直腸癌患者行腹腔鏡與行開腹根治術的比較. 中國普外基礎與臨床雜志, 2009, 16(10):789-792.
24.	Pinto RA, Ruiz D, Edden Y, et al. How reliable is laparoscopic colorectal surgery compared with laparotomy for octogenarians?. Surg Endosc, 2011, 25(8):2692-2698.

1. ?Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial):multicentre, randomised controlled trial. Lancet, 2005, 365(9472):1718-1726.
2. Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer:short-term outcomes of a randomised trial. Lancet Oncol, 2005, 6(7):477-484.
3. Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoseopically assisted and open colectomy for colon cancer. N Engl J Med, 2004, 350(20):2050-2059.
4. Fleshman J, Sargent DJ, Green E, et al. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg, 2007, 246(4):655-662.
5. Colon Cancer Laparoscopic or Open Resection Study Group; Buunen M, Veldkamp R, et al. Survival after laparoscopic surgery versus open surgery for colon cancer:long-term outcome of a randomised clinical trial. Lancet Oncol, 2009, 10(1):44-52.
6. Jayne DG, Thorpe HC, Copeland J, et al. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg, 2010, 97(11):1638-1645.
7. Roscio F, Bertoglio C, De Luca A, et al. Outcomes of laparoscopic surgery for colorectal cancer in elderly patients. JSLS, 2011, 15(3):315-321.
8. 王金保, 王姝媛, 王琪, 等. 不同氣腹壓條件下腹腔鏡膽囊摘除術患者血流動力學的變化. 臨床麻醉學雜志, 2012, 28(2):163-165.
9. Jacobs M, Verdeja JC, Goldstein HS. Laparoscopic choledocholitho-tomy. J Laparoendosc Surg, 1991, 1(2):79-82.
10. 范瑩, 吳碩東, 于宏, 等. 腹腔鏡結直腸癌根治術與同期開腹手術對比的單中心回顧性研究. 中國普外基礎與臨床雜志, 2009, 16(5):384-388.
11. 梁耀澤, 余江, 張策, 等. 腹腔鏡與同期開腹直腸癌根治術后腫瘤學結果對比研究. 中國普外基礎與臨床雜志, 2010, 17(6):591-595.
12. 周海濤, 周志祥. 腹腔鏡手術或將成為高齡結直腸癌患者的常規外科治療方法. 中華腫瘤雜志, 2014, 36(1):2-4.
13. 卞正乾, 鐘鳴, 唐偉軍, 等. 80歲以上高齡結直腸癌患者接受腹腔鏡輔助根治手術的圍手術期安全性觀察. 腹腔鏡外科雜志, 2009, 14(1):41-44.
14. 孫建萍, 伍冀湘, 張京嵐. 開腹、氣腹腹腔鏡、無氣腹腹腔鏡結直腸癌手術對高齡患者術中心肺功能的影響. 中國微創外科雜志, 2010, 10(9):826-829.
15. Kanwer DB, Kaman L, Nedounsejiane M, et al. Comparative study of low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy-a randomised controlled trial. Trop Gastroenterol, 2009, 30(3):171-174.
16. Russo A, Marana E, Viviani D, et al. Diastolic function:the influence of pneumoperitoneum and Trendelenburg positioning during laparoscopic hysterectomy. Eur J Anaesthesiol, 2009, 26(11):923-927.
17. Falabella A, Moore-Jeffries E, Sullivan MJ, et al. Cardiac function during steep Trendelenburg position and CO₂ pneumoperitoneum for robotic-assisted prostatectomy:a trans-oesophageal Doppler probe study. Int J Med Robot, 2007, 3(4):312-315.
18. Alves A, Panis Y, Mathieu P, et al. Postoperative mortality and morbidity in French patients undergoing colorectal surgery:results of a prospective multicenter study. Arch Surg, 2005, 140(3):278-284.
19. Alves A, Panis Y, Mantion G, et al. The AFC score:validation of a 4-item predicting score of postoperative mortality after colorectal resection for cancer or diverticulitis:results of a prospective multicenter study in 1 049 patients. Ann Surg, 2007, 246(1):91-96.
20. Person B, Cera SM, Sands DR, et al. Do elderly patients benefit from laparoscopic colorectal surgery?. Surg Endos, 2008, 22(2):401-405.
21. Latkauskas T, Rudinskaite G, Kurtinaitis J, et al. The impact of age on post-operative outcomes of colorectal cancer patients undergoing surgical treatment. BMC Cancer, 2005, 5:153.
22. Grailey K, Markar SR, Karthikesalingam A, et al. Laparoscopic versus open colorectal resection in the elderly population. Surg Endosc, 2013, 27(1):19-30.
23. 梁輝, 管蔚, 陳國玉. 不同年齡直腸癌患者行腹腔鏡與行開腹根治術的比較. 中國普外基礎與臨床雜志, 2009, 16(10):789-792.
24. Pinto RA, Ruiz D, Edden Y, et al. How reliable is laparoscopic colorectal surgery compared with laparotomy for octogenarians?. Surg Endosc, 2011, 25(8):2692-2698.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effects of CO₂ Pneumoperitoneum and Posture on Circulation Function for Elderly Patients with Rectal Cancer During Laparoscopic Operation

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effects of CO2 Pneumoperitoneum and Posture on Circulation Function for Elderly Patients with Rectal Cancer During Laparoscopic Operation

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Effects of CO₂ Pneumoperitoneum and Posture on Circulation Function for Elderly Patients with Rectal Cancer During Laparoscopic Operation