スエヨシ リヨウ
  末吉 亮
   所属   医学部 医学科(東京女子医科大学病院)
   職種   講師
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Pneumoperitoneum and hemodynamic stability during pediatric laparoscopic appendectomy.
掲載誌名 正式名:Journal of pediatric surgery
略  称:J Pediatr Surg
ISSNコード:15315037/00223468
掲載区分国外
巻・号・頁 51(12),pp.1949-1951
著者・共著者 Miyano Go, Nakamura Hiroki, Seo Shogo, Sueyoshi Ryo, Okawada Manabu, Doi Takashi, Koga Hiroyuki, Lane Geoffrey J, Yamataka Atsuyuki
発行年月 2016/12
概要 BACKGROUND:Conventional pneumoperitoneum (CP) and automatically maintained pneumoperitoneum using AirSeal Intelligent Flow System (AiFS) were compared during pediatric laparoscopic appendectomy (LA) using intraperitoneal pressure (IPP) and hemodynamic parameters.METHODS:A prospective review of 39 children aged 3-14years who had standard 3-trocar LA was performed. Pneumoperitoneum was either AiFS (n=18) or CP (n=21) according to the surgeon's preference. IPP during insertion of trocars in all subjects was initially 8-10mmHg, which was reduced to 5mmHg then maintained until LA was completed. Data were collected every 5min during pneumoperitoneum.RESULTS:Subject demographics were similar for both groups. During pneumoperitoneum, average IPP (AiFS: 7.9; CP: 9.0mmHg), average systolic blood pressure (AiFS: 100.4; CP: 106.9mmHg), and average end-tidal CO2 (EtCO2; AiFS: 35.7; CP: 38.5mmHg) were significantly different (p<.05, respectively), while pulse (AiFS: 92.1; CP: 96.4bpm), oxygen saturation (AiFS: 98.8; CP: 98.8%), body temperature (AiFS: 37.2; CP: 37.4), urine output (AiFS: 2.7; CP: 2.4mL/kg per hour), operative time (AiFS: 72.2; CP: 76.2mins), blood loss (AiFS: 3.6; CP: 3.5mL), recommencement of oral intake (AiFS: 1.3; CP: 1.4days), and postoperative hospitalization (AiFS: 4.3; CP: 3.8days) were not.CONCLUSION:Because IPP was significantly lower during LA with AiFS, EtCO2 and BP were significantly lower.LEVEL OF EVIDENCE:Treatment study; prospective comparative study - level II.
DOI 10.1016/j.jpedsurg.2016.09.016
PMID 28029370