老年患者腹腔镜结直肠手术的安全性研究

Objective To compare the outcomes of laparoscopic colorectal surgery in elderly (≥ 70 years) and younger (< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly. Methods From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older (Elder Group), and 15 patients less than 70 years (Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups. Results Elder group had a higher ASA degree (P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO3 value and PaCO2 value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucesa (PgCO2) increased significantly at the end of operation.Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, pedusion, and blood chemistry were not significantly different. Conclusions For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.     

老年患者腹腔镜结直肠手术的安全性研究

Objective To compare the outcomes of laparoscopic colorectal surgery in elderly (≥ 70 years) and younger (< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly. Methods From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older (Elder Group), and 15 patients less than 70 years (Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups. Results Elder group had a higher ASA degree (P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO3 value and PaCO2 value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucesa (PgCO2) increased significantly at the end of operation.Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, pedusion, and blood chemistry were not significantly different. Conclusions For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.     

老年患者腹腔镜结直肠手术的安全性研究

Objective To compare the outcomes of laparoscopic colorectal surgery in elderly (≥ 70 years) and younger (< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly. Methods From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older (Elder Group), and 15 patients less than 70 years (Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups. Results Elder group had a higher ASA degree (P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO3 value and PaCO2 value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucesa (PgCO2) increased significantly at the end of operation.Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, pedusion, and blood chemistry were not significantly different. Conclusions For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.     

老年患者腹腔镜结直肠手术的安全性研究

Objective To compare the outcomes of laparoscopic colorectal surgery in elderly (≥ 70 years) and younger (< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly. Methods From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older (Elder Group), and 15 patients less than 70 years (Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups. Results Elder group had a higher ASA degree (P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO3 value and PaCO2 value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucesa (PgCO2) increased significantly at the end of operation.Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, pedusion, and blood chemistry were not significantly different. Conclusions For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.     

老年患者腹腔镜结直肠手术的安全性研究

Objective To compare the outcomes of laparoscopic colorectal surgery in elderly (≥ 70 years) and younger (< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly. Methods From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older (Elder Group), and 15 patients less than 70 years (Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups. Results Elder group had a higher ASA degree (P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO3 value and PaCO2 value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucesa (PgCO2) increased significantly at the end of operation.Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, pedusion, and blood chemistry were not significantly different. Conclusions For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.     

老年患者腹腔镜结直肠手术的安全性研究

Objective To compare the outcomes of laparoscopic colorectal surgery in elderly (≥ 70 years) and younger (< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly. Methods From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older (Elder Group), and 15 patients less than 70 years (Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups. Results Elder group had a higher ASA degree (P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO3 value and PaCO2 value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucesa (PgCO2) increased significantly at the end of operation.Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, pedusion, and blood chemistry were not significantly different. Conclusions For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.     

老年患者腹腔镜结直肠手术的安全性研究

Objective To compare the outcomes of laparoscopic colorectal surgery in elderly (≥ 70 years) and younger (< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly. Methods From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older (Elder Group), and 15 patients less than 70 years (Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups. Results Elder group had a higher ASA degree (P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO3 value and PaCO2 value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucesa (PgCO2) increased significantly at the end of operation.Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, pedusion, and blood chemistry were not significantly different. Conclusions For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.     

老年患者腹腔镜结直肠手术的安全性研究

Objective To compare the outcomes of laparoscopic colorectal surgery in elderly (≥ 70 years) and younger (< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly. Methods From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older (Elder Group), and 15 patients less than 70 years (Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups. Results Elder group had a higher ASA degree (P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO3 value and PaCO2 value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucesa (PgCO2) increased significantly at the end of operation.Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, pedusion, and blood chemistry were not significantly different. Conclusions For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.     

老年患者腹腔镜结直肠手术的安全性研究

Objective To compare the outcomes of laparoscopic colorectal surgery in elderly (≥ 70 years) and younger (< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly. Methods From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older (Elder Group), and 15 patients less than 70 years (Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups. Results Elder group had a higher ASA degree (P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO3 value and PaCO2 value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucesa (PgCO2) increased significantly at the end of operation.Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, pedusion, and blood chemistry were not significantly different. Conclusions For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.     

压力和容量通气模式对肥胖患者腹腔镜手术中呼吸功能的影响

Objective To investigate the effects of pressure -controlled ventilation (PCV) and volume -controlled ventilation (VCV) on obese patients undergoing gynecologic laparoscopic surgery by evaluating hemodynamics and respiratory parameters, and arterial oxygenation. Methods Forty obese patients undergoing gynecological laparoscopic surgery were randomly divided into PCV and VCV group (n=20). Patients were all implemented into the program of total intravenous anesthesia, and ventilated with different modes.End-tidal carbon dioxide partial pressure (PETCO2) was maintained between(35-45 ) mm Hg. Arterial blood was collected respectively to analyze blood gas at 5 min before anesthesia (T0), 5 min before the start of pneumoperitoneum (T1),30 min after the start of pneumoperitoneum(T2), 5 min after the end of pneumoperitoneum(T3) and at extubation(T4). Meanwhile, parameters of hemodynamics and respiratory mechanics were monitored and calculated. Results 1 、At T1,T2 and T3, PaO2 and OI (460±78,453±83,463±95)were significantly higher in PCV group (P<0.05), A-aDO2(74±25,80±30,82±26) and RI (0.32±0.08,0.33±0. 10,0.34±0.13 ) was significantly lower (P<0.05) in PCV group. 2. Compared with T0, PaCO2 at T2,T3,T4 in both groups increased significantly and PH decreased significantly (P<0.05); Compared with VCV group, PCV group had no significant difference at each time point. 3. Compared with VCV group, Ppeak(27.8±1.6)in PCV group at T2 was significantly lower(P<0.05). Conclusion The ventilation/perfusion ratio was improved and gas exchange was promoted in obese patients undergoing gynecologic laparoscopic surgery with PCV model.