AirSeal智能气腹系统在腹腔镜直肠癌根治手术中的应用价值:前瞻性随机对照研究  

Application Value of AirSeal Intelligent Flow System in Laparoscopic Radical Resection of Rectal Cancer:a Prospective Randomized Controlled Study

作　　者：赵加应 殷琛庆 蔡元坤 柯重伟 王会鹏 蒋克泉 吴贵龙 Zhao Jiaying;Yin Chenqing;Cai Yuankun(Department of General Surgery, Fifth People’s Hospital of Shanghai, Fudan University, Shanghai 200240, China)

机构地区：[1]复旦大学附属上海市第五人民医院普外科,上海200240 [2]复旦大学附属上海市第五人民医院麻醉科,上海200240

出　　处：《中国微创外科杂志》2020年第5期388-391,420,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：上海市科学技术委员会科研计划项目(17411967600);上海市闵行区医疗系统大学科建设专项基金(2017MWDXK01)。

摘　　要：目的探讨AirSeal智能气腹系统在腹腔镜直肠癌根治手术中的应用价值。方法将2017年7月~2019年6月80例腹腔镜直肠癌根治手术,随机分为AirSeal组和对照组各40例,AirSeal组应用AirSeal智能气腹系统,对照组应用常规气腹机,比较2组术中擦镜次数、盆腔自主神经显示情况、手术时间、术中出血量、淋巴结清扫个数、术中动脉血气变化、肛门排气时间、腹腔引流量和并发症。结果均成功完成手术,无严重并发症和死亡。术中擦镜次数AirSeal组更少[(8.3±2.5)次vs.(12.8±3.7)次,t=-7.686,P=0.000],盆神经丛显示例数AirSeal组更多(25例vs.14例,χ^2=6.054,P=0.014),低位直肠癌手术时间AirSeal组更短[Dixon:(105.4±17.4)min vs.(136.8±25.6)min,t=-4.536,P=0.000;Miles:(145.2±17.6)min vs.(186.3±31.5)min,t=-2.829,P=0.016],术中动脉血气指标pH值、PaCO2、PaO2、BE和HCO-32组差异无显著性(P>0.05)。2组术中出血量、淋巴结清扫个数、肛门排气时间、术后腹腔引流量和术后并发症均无显著差异(P>0.05)。结论AirSeal智能气腹系统在腹腔镜直肠癌根治手术中能及时排出术中烟雾,减少术中擦镜次数,保持镜头清晰,缩短低位直肠癌腹腔镜手术时间,有一定的临床应用价值。Objective To evaluate the application value of AirSeal Intelligent Flow System in laparoscopic radical resection of rectal cancer.Methods A total of 80 cases of laparoscopic radical resection for rectal cancer admitted in our hospital from July 2017 to June 2019 were randomly divided into AirSeal group(40 cases)and control group(40 cases).The AirSeal group was given AirSeal device to establish pneumoperitoneum during operation for laparoscopic operation,while the control group used conventional pneumoperitoneum.The times of lens wiping during laparoscopic surgery,display of pelvic autonomic nerve,operation time,amount of intraoperative bleeding,number of lymph node dissection,change of intraoperative arterial blood gas,anal exhaust time,amount of abdominal drainage and complications were compared between the two groups.Results All the operations were successfully performed.No serious complications or death occurred.The times of lens wiping in the AirSeal group was less than that in the control group[(8.3±2.5)times vs.(12.8±3.7)times,t=-7.686,P=0.000].The pelvic plexus was showed more clear in the AirSeal group than in the control group(25 cases vs.14 cases,χ^2=6.054,P=0.014).The operation time of low rectal cancer in the AirSeal group was shorter than that in the control group[Dixon:(105.4±17.4)min vs.(136.8±25.6)min,t=-4.536,P=0.000;Miles:(145.2±17.6)min vs.(186.3±31.5)min,t=-2.829,P=0.016].During the operation,there were no significant differences in pH value,PaCO2,PaO2,BE and HCO3-of arterial blood gas between the AirSeal group and the control group.There were no significant differences in intraoperative bleeding,lymph node dissection,anal exhaust time after operation,postoperative drainage and postoperative complications between the AirSeal group and the control group.Conclusions In laparoscopic radical resection of rectal cancer,AirSeal can expel the fog generated during the operation in time,maintain the lens clarity,and reduce the laparoscopic operation time for low rectal cancer.It has certain clin

关 键 词：气腹 直肠癌 腹腔镜手术 

分 类 号：R73[医药卫生—肿瘤]