A Clinical Study On The Effect Of CO₂ Pneumoperitoneum To Venous Flow Of Lower Extremity In Laparoscopic Colorectal Operations

Objective:To study the effect of CO2 pneumoperitoneum on lower extremity venous flow during laparoscopic colorectal operations, meanwhile to obtain the reference for perioperative measures to prevent deep venous thrombosis during laparoscopic surgery.Methods:Clinical data of 72 patients with colorectal carcinoma was collected in Gastrointestinal Department, Shenzhen People's Hospital from April 2009 to March 2010, in which 39 cases were undergone laparoscopic surgery, meanwhile 33 cases were undergone traditional open surgery. In laparoscopic surgery group, femoral vein cross-sectional area and maximum velocity were measured by Color Doppler ultrasound at each time point:followed anesthesia,20min after the establishment of pneumoperitoneum, and 20min after its exhaustion; In traditional open group, the data above was also measured at each time point: followed anesthesia,20min after the abdomenal incision and 20min postsurgery. Then, the cases were divided into 4 groups based on the age:group A(20 cases):>60y with laparoscopic surgery; group B(19cases):<60y with laparoscopic surgery; group C(17cases):>60y with traditional open surgery; group D(16cases):<60y with traditional open surgery, compared the femoral vein hemodynamics indexes at each time point among the four groups.Results:By contrast to the traditional open group, in laparoscopic surgery group the femoral vein cross-sectional area increased significantly(P<0.05), meanwhile the blood velocity and the volume of the blood flow decreased significantly(P<0.05); By contrast to group B, the data above changed more apparently in group A, which had a significant difference(P<0.05). In laparoscopic surgery group, femoral vein cross-sectional area and blood velocity recovered instantly after the exhaustion of CO2 gas, but the average data in different time point also had a difference(P<0.05).Conclusions:Laparoscopic colorectal surgery CO2 pneumoperitoneum obstacle venous flow, which changed more apparently in the patients over 60y. For elder patients who need to undergo laparoscopic colorectal operations, some measures to prevent deep venous thrombosis should be taken in perioperative period.