A Comparative Analysis On The Hemodynamic Between Transtroperitoneal Laparoscopy And Retropeitoneal Laparoscopy

Objective: We compare the ventilatory and hemodynamic change during the retroperitoneal laparoscopy and laparoscopic surgery,in order to evaluate the safety of the two approaches.Materials and Methods: Form January 2014 to September 2014 we included in the study 37 patients requiring retroperitoneal laparoscopic surgery and 32 patients requiring transperitoneal laparoscopic surgery,.The initial tidal volume set up 8ml kg-1. The end tidal carbon dioxide partial pressure, respiratory rate,blood pressure, finger arterial oxygen saturation, peak inspiratory pressure is measured at the following six points: time after induction of anesthesia,5mintues after positioned,the 15 min,30min and 60 min after CO2 insuff Iations and 10 minutes after exsuff Iation. The Chi square test, wilcoxon test and repeated measurement ANOVA were used to compare the differences of those data.Results:The differences of peak inspiratory pressure, systolic pressure and diastolic pressure between the two groups had no statistical significance(P>0.05). The end tidal carbon dioxide partial pressure difference between two groups had statistical significance.(P<0.05). The inter-group comparison of end tidal carbon dioxide partial pressure, peak inspiratory pressure, systolic blood pressure and diastolic pressure after CO2 insufflation are statistical significance(P<0.05).The Et PCO2(>45mm Hg) frequency was 8(8/214), while the transperitoneal group Et PCO2(> 45 mm Hg) frequency was18(18/174). The difference was statistically significant between the two groups(P<0.05).Conclusion:Retroperitoneal approach and transperitoneal surgical approach could induce significant change in partial pressure of carbon dioxide, peak inspiratory pressure, systolic and diastolic blood pressure, and the transperitoneal CO2 insuff Iation tends to cause much more change in the respiratory measurements. We should enhance the inspection of the hemodynamics and pulmonary function in the transperitoneal laparoscopy to ensure the stable vital signs of patients.